ENVIRONMENTAL MEDICINE               

Definitions

• Environmental medicine - an approach to medical care dedicated to the evaluation, management, and prevention of adverse consequences resulting from Environmentally Triggered Illnesses.

• Ecology – branch of biology that deals with the relationship between living organisms and their environment. All living things are interconnected.

• Pesticide - collective term that includes fungicides, herbicides, insecticides, and termiticides

• Pollution - unwanted material released into the environment by human activity.

• Xenobiotic - chemicals or molecules which are foreign to biological systems. These can cause cancer and/or alter the normal functioning of the biological system.

Regulation of environmental toxins

• No single regulatory agency oversees industrial chemicals (including pesticides, herbicides, household cleaners) to ensure their safety.

• Industrial chemicals are presumed safe until proven hazardous.

• Any toxicity testing that is done typically involves individual compounds rather than the complex mixtures of chemicals that exist in our current environment.

Statistics – chemicals in the environment

• There are over 80,000 chemicals used in the US (2004) and registered with the EPA, with 1600 new ones submitted for approval every year; less than 10% have been evaluated for safety, and most that have been evaluated for safety have been studied only in young healthy males (not pregnant women or children), and studied in isolation, not in combination with other chemicals (Rapp, Doris J. Our Toxic World. 2004).

  • Approximately 60,000 chemicals, were "grandfathered" in before the Toxic Substances Control Act (TSCA) took effect in 1976. Prior to 1976, the government had a 90-day window to prove if the substance was toxic to humans. If no harm was proven, the chemical was allowed on the market with its identity masked to protect industrial trade secrets.

  • Even after 1976, special exemptions remain available to manufacturers to shield chemical identities and specifics from all but a few select employees of the EPA. An estimated 17,000 chemicals are in use under this exemption in the US.

  • In 2016, there was an overhaul to the TSCA of 1976. The new law, called the Lautenberg Act, specifically requires the EPA to consider exposures among vulnerable populations when evaluating chemicals.

• There are over 3800 high-volume chemicals produced in the U.S. Less than half have been tested for toxic effects on humans and less than 10% have been tested for toxic effects on children.

• 1500 hazardous substances can be found in the typical North American home.

• There are over 10,000 food and chemical additives allowed into the U.S. food supply.

• Of 64 active pesticides used in schools, data suggests that 16 are probable causes of cancer, 24 are related to birth defects, 44 appear to cause reproductive problems, 49 can affect the central nervous system, 54 can damage the kidneys, and 59 may cause eye and skin problems (Rapp, Doris J. Our Toxic World. 2004).

• There are approximately 16,000 different pesticide products used in the U.S. and there are approximately 600 approved pesticide active ingredients.

• According to the EPA, 1.23 billion pounds of chemicals (which are potentially harmful to humans) are used (released into the air and water) annually in the U.S. (1998 data).

• According to the EPA, in 2000 more than 4 billion pounds of chemicals were discharged into the ground, nearly 2 billion pounds of chemicals were released into the atmosphere, and over 260 million pounds of chemicals were discharged into surface waters.

• More than 65,000 metric tons of flame retardants (containing PBDE) are manufactured each year - these are used in a variety of consumer products such as fabrics and Styrofoam.

• As many as 40 distinct carcinogens may be in our water supply.

• As many as 60 distinct carcinogens are released into the air by industrial processes.

• As many as 66 distinct carcinogens are sprayed on food crops as pesticides.

• Fertilizer, especially ‘Zn fertilizer’ is sometimes manufactured from industrial waste – in one study, 20 of 29 fertilizers purchased in 12 states contained levels of toxins (i.e. arsenic, cadmium, chromium, lead, mercury, and dioxins) that exceeded EPA limits.

• According to the rules that govern the chemical industry, new compounds for human use can be introduced without proof of safety - once on the market they must be proved unsafe to be removed from the market.

• Recent research from the American Water Works Association has found significant amounts of prescription drugs including birth control hormones in the water supply, along with herbicides and fragrances.

• Voltaren in dead cattle is causing renal failure in vultures, resulting in a 99% drop in the vulture population of India over a decade, and interrupting an ecological cycle (Nature. 2004. 427. 630-633).

Pollution/environmental toxin exposure and effects on humans

• Categories of adverse health effects

  • Carcinogenesis

  • Endocrine disruption (especially thyroid and sex hormones)– extremely low levels are pertinent (i.e. bisphenol A is equipotent with estradiol at levels of only ppt, in part because all BPA circulating in the blood is free, whereas 99% of the circulating estradiol is bound by serum proteins).

  • Immunologic dysfunction

  • Inflammation – inflammatory cytokine upregulation, stimulation of tumor necrosis factor

  • Metabolic disruption (blood sugar regulation disruption)

  • Methylation disruption

  • Mitochondrial damage

  • Neurotoxicity

  • PPAR agonist - POPs

• Body burden testing – chemicals in our bodies

  • Bill Moyers – as a part of the 2001 PBS series, Mt Sinai School of Medicine analyzed Bill Moyer’s blood and urine and identified 84 distinct chemicals, many of which are known to be carcinogenic or hormone disruptors.

  • Infants – Environmental Working Group (www.ewg.org) in 2005 analyzed umbilical cord blood from 10 babies and found an average of 200 industrial chemicals and pollutants

  • Testing of non-occupationally exposed adults for 215 common high use compounds revealed evidence of 167 of the 215 compounds in humans, with an average of 91 toxins per person (www.ewg.org)

    • 76 chemicals of the 167 linked to cancer in humans or animals (average of 53 per person)

    • 94 chemicals of the 167 are toxic to the brain and nervous system (average of 62)

    • 86 chemicals of the 167 interfere with the hormone system (average of 58)

    • 79 chemicals of the 167 are associated with birth defects or abnormal development (average of 55)

    • 77 chemicals of the 167 are toxic to the reproductive system (average of 55)

    • 77 chemicals of the 167 are toxic to the immune system (average of 53)

  • CDC environmental health lab in 2005 is monitoring the concentrations in blood and urine of 150 chemicals found in common household supplies, including phthalates (plasticizers), disinfectants, and insecticides. This program is monitoring chemical exposure, not health risk.

  • CDC - National Report on Human Exposure to Environmental Chemicals, based on NHANES data.

    • First report issued in March 2001, based on exposure data for 27 chemicals in NHANES 1999-2000.

    • Second report issued in January 2003, based on exposure data for 116 chemicals in NHANES 1999-2000.

    • Third report issued in July 2005, based on exposure data for 148 chemicals in NHANES 2001-2002.

    • Fourth report issued in 2009, based on exposure data for 212 chemicals from NHANES 1999-2004 (Altern Med Review. 2010. 15[2]. 101-119).

    • There have since been several updates.

• Precocious puberty is increasing, and there is data that much of the increase is related to environmental xenoestrogens (i.e. phthalates, shampoos and personal care products with estrogenic substances, which are widely used in African American communities).

• One study showed that 27% of African American girls began developing breasts and pubic hair by age 7; 48% reached this stage by age 8. 3% of African American girls and 1% of Caucasian girls showed breast development and pubic hair by age 3! (Pediatrics. 1997. 99. 505-512).

• Data from NHANES 1988-1994 showed that 49% of African American girls showed breast development by age 9, compared with 24.5% of Mexican Americans and 15.8% of Caucasians (Pediatrics. 2002. 110. 752-757).

• Sperm counts in men have dropped from 125 million/ml in 1932 to 50 million/ml in 1998; size of genitals in males is smaller in those individuals with higher levels of pesticides and phthalates.

• Dioxins (more information below) bioaccumulate in fatty tissue; highest levels are in breast milk.

• Mercury - in 2005, interim results from Greenpeaces Mercury Hair Sampling Project at the University of North Carolina-Asheville reported that mercury levels exceeded the EPA limit of 1 microgram of mercury per gram of hair in 21% of the 597 women of childbearing age tested. Mercury levels were correlated with fish consumption.

• PBDEs (more information below) - potential effects on human health are unknown; toxicological studies show that these compounds are neurotoxins, carcinogens, and endocrine disruptors.

• PFCs (more information below) – carcinogenic in animals, and probably in humans

• Persistent organic pollutants (i.e. PCBs, dioxins, furans, pesticides) bio-accumulate in humans over time. Among approximately 1900 subjects selected in 1999 and 2000 from the NHANES III database, at least 90% had detectable levels of DDT, and at least 50% had detectable levels of urinary organophosphate insecticide metabolites (DHHS publication # 02-0716. 2003).

• Phthalates (more information below) – endocrine disruptors

Pollution and human health/disease

• in 2011, World Health Organization (WHO) estimated that 4.9 million deaths and 86 million Disability Adjusted Life Years could be attributed to environmental chemicals (Int J Env Res & Pub Hth. 2016. 13. 181 ).

• The Global Burden of Disease (GBD) study estimates that pollution was responsible for 9 million deaths worldwide in 2019 (Lancet. 2018. 391. 462-512).

• It is estimated that 1/4 of the global disease burden and 1/3 of the burden in children under age 5 is due to modifiable environmental factors (Int J Env Res & Pub Hth. 2016. 13. 181 ).

• Environmental pollutant-related illness in children costs $54.9 billion annually in the U.S. including $43 billion for lead poisoning, $9.2 billion for neurobehavioral disorders, $2 billion for asthma, 0.3 billion for childhood cancers (Environ Health Perspect. 2002. 110. 721-728).

• Children are at highest risk

  • Consume more air, food and water per body weight

  • Put more things in their mouths

  • Breathing zones closer to the ground

  • Detoxification mechanisms immature

• Incidence rates for childhood cancer increased 21 % between 1975 and 1998, approximately 1 % each year, due to unexplained environmental influences. An expert panel convened by Mt Sinai Hospital concluded that genetic predisposition accounts for only approximately 20% of childhood cancers.

• Arsenic and diabetes type II (Kile ML and Christiani DC. Editorial. JAMA. 2008. 300. 845-846)

  • An estimated 100 million people worldwide are exposed to high arsenic from contaminated drinking water (actually most often from contamination of water from natural mineral deposits rather than pollution) [Appl Geochem. 2002. 17. 517-568]. In the US, approximately 13 million people live in areas with a concentration of inorganic arsenic in the public water supply that exceeds the EPA standard of 10 mcg/L (Fed Regist. 2001. 66. 6976-7066).

  • Arsenic exposure was first linked to diabetes in 1950 based on a case report of diabetes developing in an individual receiving intravenous arsenical treatment for a STD (Am J Med. 1950. 9. 124-132).

  • In multiple epidemiologic studies in the 1990’s, high chronic exposure to inorganic arsenic in drinking water (>100 mcg/L) is associated with diabetes, with a dose response relationship noted.

  • High occupational exposure to organic arsenic (arsenobetaine) is associated with higher levels of glycosylated hemoglobin (Analyst. 1998. 123. 77-80).

  • Humans are exposed to organic arsenic compounds in seafood, but these are metabolized into compounds considered nontoxic (Carcinogenesis. 1991. 12. 1287-1291).

  • NHANES IV data (2003-2004) in 788 adults who had a urinary arsenic determination showed that after adjustment for biomarkers of seafood intake, total urinary arsenic was associated with increased prevalence of diabetes type II. After adjustment for diabetes risk factors and markers of seafood intake, the odds ratio for diabetes type II in participants in the 80th vs. the 20th percentile of total urinary arsenic was 3.58 (whereas the odds ratio was 0.69 for arsenobetaine, the organic arsenic compound found in seafood) [JAMA. 2008. 300. 814-822]. Calculations would suggest that even those individuals in with the highest percentile of total urinary arsenic were exposed to less than the current EPA standard of 0.3 mcg/kg of body weight/day. A limitation of this data is that urinary arsenic, with a half life of approximately 3 days, is a biomarker of short term exposure to arsenic (Editorial. JAMA. 2008. 300. 845-846).

  • Toenail arsenic levels correlate with diabetes (Am J Epidemiol. 2013. 178. 1563-1570).

• Arsenic and cardiovascular disease (inorganic arsenic occurs naturally in groundwater)

  • High arsenic in drinking water (>100 mcg/L) is associated with increased risk of peripheral vascular disease, coronary heart disease, stroke, and carotid atherosclerosis, based on studies in studies in Taiwan, Bangladesh, Chile, Inner Mongolia, and Pakistan (References 2-11 of Ann Intern Med. 2013. 159. 649-659).

  • A prospective cohort study of 3575 American Indian men and women, with 20 years of follow up, shows that “exposure to low to moderate levels of arsenic, as measured in the urine, was associated with increased risk for fatal and nonfatal cardiovascular disease (Ann Intern Med. 2013. 159. 649-659 and editorial 713-714).

• Cadmium and cardiovascular disease - a systematic review shows a dose-dependent increase in risk of all CV endpoints except stroke, even at very low exposures to cadmium (Curr Atheroscler Rep. 2013. 15. 356).

• Lead and adverse health outcomes

  • Lead is estimated to cause 901,000 deaths globally in 2019, with nearly 75% of those deaths due to CV disease (BMJ. 2018. 362. k3310).

  • Lead is a known risk factor for HTN, based on data from a meta-analysis (J Hum Hypertens. 2002. 16. 123-131).

  • Serum lead levels even within the ‘normal’ range (i.e. < 10 mcg/dl) are associated with adverse health outcomes

    • 12 year data in 13,946 adults who had serum lead measured at baseline as part of NHANES III showed that those in the highest tertile (mean level greater than 3.63 mcg/dl) had a 25% greater risk for all cause mortality and a 55% greater risk for cardiovascular mortality, compared with those in the lowest tertile (mean level less than 1.94 mcg/dl) [Circulation. 2006. 114. 1388-1394].

    • Data from long term follow up of 14,289 participants from NHANES III suggests that the relationship between lead and mortality from CV disease extends down to lead levels below 3 ug/dl (Lancet Public Health. 2018. 3. e177-e184).

• Mercury and the risk of MI; the data is mixed

  • One case control study in 8 European countries and Israel with 684 men with a first diagnosis of MI and 724 controls showed a direct association (N Engl J Med. 2002. 347. 1747-1754).

  • However a nested case control study in male health professionals comparing 470 men with a new diagnosis of CAD with 470 controls did not find an association (N Engl J Med. 2002. 347. 1755-1760).

  • A systematic review and dose-response meta-analysis suggests a dose-dependent increase in risk from CV disease and nonfatal MI with increased mercury levels (Environ Res. 2021. 193. 110538).

• Bisphenol A (BPA) and obesity

  • Data in 2838 participants (aged 6-19 years) in NHANES 2003-2008 show that “Urinary BPA concentration was significantly associated with obesity in this cross sectional study of children and adolescents.” Uncertain whether this is cause and effect versus whether obese children consume greater quantities of processed food with BPA in the packaging (JAMA. 2012. 308. 1113-1121).

• Bisphenol A and diabetes

  • Urinary BPA levels are correlated with increased risk of diabetes (JAMA. 2008. 300. 1303-1310).

• Organochlorine exposure and thyroid disease

  • Levels of organochlorine pollutants are associated with the risk of autoimmune thyroiditis (Chemosphere. 2007. 69. 118-127).

• PFOA (perfluorooctanoic acid) and cardiovascular disease

  • Data in 1216 subjects in NHANES 1999-2003 shows that exposure to PFOA (as determined by serum levels) is associated with CVD (self reported) and PAD (defined as ABI < 0.9). PFOA has been widely used in the manufacture of industrial and consumer products, such as surfactants, lubricants, polishes, paper and textile coating, food packaging, and fire-retarding foams. Drinking water is the primary route of exposure in most populations (Arch Intern Med. 2012. 172. 1397-1403 and Invited Commentary 1403-1405).

• POPs (persistent organic pollutants) – these include dioxins, PCBs, pesticides and herbicides

  • In the NHANES Survey, 1999-2002, there was a strong positive association between serum concentrations of persistent organic pollutants (mainly pesticides and herbicides) and prevalence of type 2 diabetes. Subjects in the highest category (> 90th percentile) of exposure, as compared with the lowest category (< 25th percentile), had a 38-fold increase in risk of type 2 diabetes. Obesity was not a risk factor for type 2 diabetes in people with undetectable levels of persistent organic pollutants (Diabetes Care. 2006. 29. 1638-1644).

  • An editorial addressing the above data states it appears “virtually all of the risk of diabetes conferred by obesity is attributable to persistent organic pollutants, and that obesity is only a vehicle for such chemicals. This possibility is shocking.” (Lancet. 2006. 368. 558-559).

  • Exposure to persistent organic pollutants (POPs) is also correlated with metabolic syndrome (Diabetologia. 2007. 50. 1841-1851).

  • In a cohort of 749 non-diabetic patients in NHANES, there was a clear correlation between exposure to organochlorine pesticides and insulin resistance (Diabetes Care. 2007. 30. 622-628).

  • The increase in diabetes prevalence correlates closely with the release of POPs into the environment (Diabetes. 2011. 60. 1838-1848).

Air pollution and human health

• Historical Notes (Editorial. N Engl J Med. 2017. 376. 2591-2592).

  • In 1948 a dense smog descended over the town of Donora, PA, and this dense smog was associated with illness in thousands and death of at least 20 people. Similarly, poor air quality during the London fog of 1952 was associated with increased mortality.

    • These incidents transformed the scientific perception of smog from a nuisance to a potential killer.

  • United States government began to address air quality in 1963, with passage of the Clean Air Act. This was amended in 1970 to institute National Ambient Air Quality Standards, which set exposure limits for 6 major pollutants, including fine particulate matter.

  • A 2011 EPA report estimated that by 2020, the Clean Air Act would prevent more than 230,000 premature deaths in the US. In 2012, the US EPA set an annual PM2.5 level of 12 mcg/cubic meter.

• Air pollution is a complex mixture of compounds in gaseous phase (ozone, carbon monoxide, and nitrogen dioxide) and particulate matter (Editorial. Arch Intern Med. 2008. 168. 911-913). Concentration and composition of air pollution varies by time and place and is greatly influenced by the weather (Circulation. 2010. 121. 2331-2378).

  • Particulate matter is a heterogeneous amalgam of solids and liquids (carbon, sulfates, nitrates, and metals) derived primarily from the combustion of fossil fuels.

  • Particulate matter is subdivided into ultrafine particulate matter <0.1 micrometers in aerodynamic diameter, fine particulate matter <2.5 micrometers in aerodynamic diameter and course particulate matter <10 micrometers in aerodynamic diameter.

  • The most compelling data on air pollution and human disease implicates the particulate matter (Circulation. 2004. 109. 2655-2671), and specifically the fine particulate matter (JAMA. 2006. 295. 1127-1134) – the greatest risk appears to be to the cardiovascular system, with risk to the lungs also documented, and emerging data on an increased risk of cognitive impairment and DVT (see just below for specific studies with citations).

  • Most of the epidemiologic data examines various endpoints as a function of the total level of particulate matter (i.e. particulate matter <10 micrometers in aerodynamic diameter, PM10) – using a database assembled for 108 US counties, researchers concluded that after adjustment for fine particulate matter (PM2.5), there were no statistically significant associations between course particulate matter pollution (i.e. aerodynamic diameter between 2.5 and 10 micrometers) and hospital admissions for cardiovascular and respiratory diseases (JAMA. 2008. 299. 2172-2179).

  • Since 1997 in the US, as specified in the Clean Air Act, PM2.5 as an annual average must be < 15 micrograms/meter3. There is tremendous variability in PM2.5, both as a function of time at a given location and also as a function of location (i.e. adjacent to a major roadway).

• Air pollution is an important determinant of population health. However, publication of data on the adverse health effects of air pollution is a relatively new development in the history of science (Logan WP. Mortality in the London fog incident, 1952. Lancet. 1953. 1[6755]. 336-338).

• Air pollution and total mortality

  • Long term exposure to fine particulate air pollution is associated with increased total mortality in population based studies (Science. 1970. 169. 723-733; Environ Int. 1984. 10. 55-83; Risk Anal. 1987. 7. 449-461) and a number of cohort studies (references 4-11 as cited in N Engl J Med. 2009. 360. 376-386).

  • In high income countries, 2.5% of all deaths are attributable to air pollution (N Engl J Med. 2010. 363. 1196-1198).

  • The American Cancer Society Cancer Prevention Study II has followed a cohort of 1.1 million people since enrollment in 1980, and provides consistent evidence of an association between air pollution and increased mortality (Krewski D et al. Special Report published by the Health Effects Institute in Cambridge MA. 2009).

  • The World Health Organization estimated in 2002 that air pollution is responsible for 800,000 premature deaths worldwide each year, which means that means that particulate matter ranks as the 13th leading cause of global mortality. Furthermore, the WHO estimates that 1.4% of all deaths and 0.8% of disability-adjusted life years are the result of particulate air pollution (citations are the WHO web site).

  • “The World Health Organization (WHO) estimated that in the year 2012, ambient air pollution was responsible for 3.7 million deaths, representing 6.7% of all-cause deaths, and tripling the 2008 estimates. Worldwide, air pollution causes 16% of deaths due to lung cancer, 11% of deaths due to chronic obstructive pulmonary disease, more than 20% of deaths due to ischemic heart disease and stroke, and 13% of deaths due to respiratory infections” Commentary: The health and economic burden of air pollution. Am J Med. 2015. 128. 931-932).

  • Globally, an estimated 3.3 million annual premature deaths (5.86% of global mortality) are attributable to outdoor air pollution (Nature. 2015. 525. 367-371).

  • Short-term exposure to PM2.5 and PM10 are associated with all-cause, respiratory, and cardiovascular mortality, with no apparent lower threshold effect, based on data from a time-series study which included almost 60 million deaths from 652 cities in 24 countries (N Engl J Med. 2019. 381. 705-715 and editorial 774-776).

  • GOOD NEWS – an intervention study in Dublin, Ireland showed that showed that reduced exposure to air pollution was associated with a reduction in mortality (Lancet. 2002. 360. 1210-1214)

  • GOOD NEWS - prospective follow up of the Harvard Six Cities study (initial data published N Engl J Med. 1993. 329. 1753-1759) showed that reduced exposure to air pollution (specifically reduced exposure to PM2.5 was associated with a reduction in mortality from all causes (Am J Respir Crit Care Med. 2006. 173. 667-672).

  • GOOD NEWS - prospective data in 211 county units in 51 metropolitan areas in the U.S. with matching data on fine-particulate air pollution from the late 1970’s and early 1980’s as well as the late 1990’s and early 2000s shows that reductions in air pollution (i.e. PM10) accounted for as much as 15% of the overall increase in life expectancy in the study areas (N Engl J Med. 2009. 360. 376-386).

  • GOOD NEWS - in the U.S. air pollution levels have dropped by 70% between passage of the Clean Air Act in 1970 and 2018 (J Allergy Clin Immunol. 2019. 143. 1979-1987). The EPA estimates that for every dollar invested in air pollution control between 1970-2020, there is a $30 return on investment.

  • "BAD" NEWS - there appears to be no safe level of PM2.5, with "significant evidence of adverse effects related to exposure of PM2.5 and ozone concentrations below current national standards. This effect was most pronounced amongst self-identified racial minorities and people with low income." The data is derived from an open cohort study of all Medicare beneficiaries (60,925,443 persons) in the continental US between 2000 and 2012, with annual exposure to PM2.5 estimated according to zip code. For every increase of 10 mcg/cubic meter in PM2.5, there was an associated 7.3% increase in all-cause mortality (N Engl J Med. 2017. 376. 2513-2522 and editorial 2591-2592).

• Air pollution and breast cancer - high PM2.5 exposure is associated with an increased risk for more aggressive forms of breast cancer (Prada D et al. Breast Cancer Res Treat. ePub 3/8/21).

• Air pollution and cardiovascular disease

  • Biologic mechanism to explain harm - systemic inflammation and oxidative stress lead to increased formation of atherosclerotic plaque (Clin Sci. 2008. 115. 175-187).

  • Magnitude of impact of air pollution (specifically particulate matter) upon cardiovascular disease may be greater than magnitude of impact upon pulmonary disease.

  • American Heart Association in a scientific statement concludes that overall evidence is consistent with particulate matter playing a causal role in cardiovascular morbidity and mortality (Circulation. 2010. 121. 2331-2378).

  • Epidemiologic and observational clinical studies have suggested that exposure to air pollution may worsen the symptoms of angina (Circulation. 2005. 112. 3073-3079), exacerbate exercise induced myocardial ischemia (Circulation. 2002. 106. 933-938; Environ Health Perspect. 2005. 113. 883-887), trigger acute MI (Circulation. 2001. 103. 2810-2815; N Engl J Med. 2004. 351. 1721-1730), and trigger stroke (Stroke. 2005. 36. 2549-2553).

  • Short term exposure to particulate air pollution might trigger an acute cardiovascular event (Circulation. 2006. 114. 1863-1872).

  • Long term exposure to fine particulate air pollution is associated with an increased incidence of cardiovascular disease and a 76% increased risk of death from cardiovascular disease, based on data in 65,893 postmenopausal women in the WHI observational study (N Engl J Med. 2007. 356. 447-458 and editorial 511-513).

  • Multiple prospective cohort studies show a robust causal association between long term exposure to fine particulate air pollution an mortality from cardiovascular disease (Environ Health Perspect. 2012. 120. 708-714; J Am Coll Cardiol. 2020. 75. 7-707-717; J Am Heart Assoc. 2021. 10. e016890).

  • Diesel exhaust is an important component of fine particulate matter (Environ Health Perspect. 2000. 108. 941-947); a crossover RCT in 20 men with prior MI who were experimentally exposed to dilute diesel exhaust concluded that brief exposure to dilute diesel exhaust promotes myocardial ischemia and inhibits endogenous fibrinolytic capacity in men with stable coronary artery disease (N Engl J Med. 2007. 357. 1075-1082).

  • Short term exposure to fine particulate matter (aerodynamic diameter < 2.5 micrometers) is associated with an increased rate of hospitalization for heart failure, based on analyzing hospitalization data of patients with a diagnosis of heart failure who lived in a well defined geographic area with long term daily monitoring of particulate matter, a substantial temporal variability in the level of fine particulate matter (Am J Cardiol. 2008. 102. 1230-1234). EPA data on 20,920 heart failure patients shows that a 1 mcg/m3 increase in fine particulate matter (PM2.5) was associated with a 9.31% increase in total hospital visits, a 4.35% increase in inpatient admissions, and a 14.2 % increase in 30-day readmissions (J Am Heart Assoc. 2021. 10. e019430).

  • A systemic review and meta-analysis of 34 studies shows that all the main air pollutants, with the exception of ozone (i.e. carbon monoxide, nitrogen dioxide, sulfur dioxide, PM10 and PM2.5) were associated with an increase in the risk of ‘near term’ MI (JAMA. 2012. 307. 713-721).

  • Cohort studies show higher rates of cardiopulmonary death in participants living in areas with high PM2.5 (N Engl M Med. 2007. 356. 447-458; Environ Health Perspect. 2012. 120. 965-970; N Engl M Med. 2017. 376. 2513-2422).

  • Air pollution is also associated with an increased risk of atrial fibrillation and ventricular arrhythmias (Circulation. 2020. 142. 858-867).

• Air pollution and cerebrovascular disease

  • Exposure to particulate matter is associated with a significant increase in stroke related mortality (Environ Health Perspect. 2002. 110. 187-191) and stroke hospitalizations (Neuroepidemiology. 2010. 34. 131-142).

  • A review of medical records of 1705 Boston area patients hospitalized with neurologist-confirmed ischemic stroke suggests that “exposure to PM2.5 levels considered generally safe by the US EPA increase the risk of ischemic stroke within hours of exposure” (Arch Intern Med. 2012. 172. 229-234).

• Air pollution and cognitive decline

  • Data in 19,409 US women aged 70-81 years in the Nurses’ Health Study Cognitive Cohort shows that long term exposure to both fine particulate matter (PM2.5) and course particulate matter (PM2.5-10) “at levels typically experienced by many individuals in the United States is associated with significantly worse cognitive decline in older women” (Arch Intern Med. 2012. 172. 219-227).

  • A study in 998 women ages 73 - 87 who were free of dementia at baseline showed that the greater the exposure to PM2.5 (based on EPA data on air pollution at the home address of each participant) the greater the declines in immediate recall and new learning, and the greater the atrophy on brain MRI. For each increase of 2.81 mcg/cubic meter, the annual rate of decline on cognitive testing accelerated 15 - 19.3% (Brain. 2020. 143. 289-302).

  • A systematic review and meta-analysis reported that an increase of 10 mcg/meter cubed of PM2.5 was associated with a increased relative risk of dementia of 3.26 (95% CI 1.20 - 5.31) [Environ Res. 2019. 177. 108638].

• Air pollution and risk of deep venous thrombosis (DVT)

  • There is data that exposure to particulate air pollution causes hypercoagulability (J Thromb Haemost. 2006. 4. 252-260).

  • A 10 year long case control study in Italy found that long term exposure to particulate air pollution is associated with increased risk of DVT. The magnitude of the reported risk in this case control study is large (Arch Intern Med. 2008. 168. 920-927 and editorial 911-913).

• Air pollution and depression

  • A systematic review of 39 small studies found a small but significant increase in the relative risk of depression among those with a high asked exposure to p.m. 2.5 (Borroni E et al. Environ Pollut. 2022).

  • In a cohort of 1423 women and men previously diagnosed with bipolar disorder, "As air quality worsen, symptoms of depression increased" (Candola A, Hayes J.  BJPsych Open. 2023).

  • Possible mechanism of action - fine particulate matter has been linked to neuroinflammation, neurotoxicity, and hormonal dysregulation.

• Air pollution is causally linked to diabetes, and globally airborne PM2.5 is estimated to contribute to 3.2 million incident cased of DM per year (J Clin Invest. 2020. 130. 6034-6040).

• Air pollution is causally linked to hypertension (Eur Heart J. 2017. 38. 557-564).

• Air pollution and pulmonary disease

  • Numerous epidemiologic studies have shown associations of chronic exposure to particulate matter either < 2.5 micrometers in aerodynamic diameter (PM2.5) or < 10 micrometers in aerodynamic diameter (PM10) with decreased lung function (Am J Respir Crit Care Med. 1994. 149. 1209-1217; Am J Respir Crit Care Med. 1997. 155. 122-129; Am J Respir Crit Care Med. 1998. 158. 289-298; Occup Environ Med. 2004. 61. 350-357) and mortality (N Engl J Med. 1993. 329. 1753-1759; Am J Respir Crit Care Med. 1995. 151. 669-674; Am J RespirCrit Care Med. 1999. 159. 373-382; JAMA. 2002. 287. 1132-1141; Lancet. 2002. 360. 1203-1209; Environ Health Perspect. 2004. 112. 610-615) without evidence of a threshold level.

  • A randomized crossover study in 60 adults with either mild or moderate asthma showed that exposure to diesel traffic was associated with asymptomatic but consistent reductions in lung function and these changes in lung function were associated with increases in biomarkers of neutrophilic inflammation. The methodology of this study was that each participant walked for 2 hours along a London street and, on a separate occasion, through a nearby park. Exposure to PM2.5 was measured in each location (N Engl J Med. 2007. 357. 2348-2358).

  • Long term exposure (2000-2018) to ambient air pollutants (PM2.5, nitrous oxide, black carbon, and especially ozone) in the MESA cohort of 7071 study participants in 6 US metropolitan areas was significantly associated with worsening of emphysema as measured by both quantitative CT imaging and pulmonary function testing (JAMA. 2019. 322. 546-556).

  • GOOD NEWS - the Swiss Cohort Study on Air Pollution and Lung Diseases in Adults, a prospective study in 9651 adults randomly selected from population registries in 1990 and assessed in 1991 (initial data published Am J Respir Crit Care Med. 1997. 155. 122-129) showed that the decline in overall exposure to air pollution the 8047 participants reassessed in 2002, and specifically to home outdoor PM10 (particulate matter with an aerodynamic diameter less than 10 micrometers) correlated with attenuation of the decline in lung function related to exposure to PM10 (N Engl J Med. 2007. 357. 2338-2347).

  • GOOD NEWS - in a longitudinal study involving 4602 children from 3 cohorts in Southern California, "Decreases in ambient pollution levels were associated with statistically significant decreases in bronchitic symptoms in children" (JAMA. 2016. 315. 1491-1501).

  • GOOD NEWS - in a longitudinal cohort drawn from 3 waves of an epidemiologic study, data showed “Among children in Southern California, decreases in ambient nitrogen dioxide and PM2.5 between 1993 and 2014 were significantly associated with lower asthma incidence. There were no statistically significant associations for ozone or PM10 (JAMA. 2019. 321. 1906-1915 and editorial 1875-1877).

EMF pollution and human health

• The collective results of three meta-analyses show a statistically significant association between intensity of magnetic fields (with magnetic field strengths ranging from 0.1 microT ot 2.38 microT) and incidence of childhood leukemia (Altern Ther Health Med. 2023. 29(8). 75-81).

• Cell phones - conflicting published data on risks

• Cell phone towers (5G networks) - conflicting published data on risks

• Power lines - conflicting published data on risks

• WiFi hot spots - conflicting published data on risks

• Electrohypersensitivity (EHS) - clinical syndrome

  • Description (World Health Organization 2005 fact sheet 296) – “EHS is characterized by a variety of non-specific symptoms … (and) resembles MCS, another disorder associated with low-level environmental exposure to chemicals …” NOTE in 2020 no ICD-10 code exists.

  • Symptoms (which arise or increase upon exposure to EMF) include headache, dysesthesia, ear heat/otalgia, dizziness, tinnitus, concentration/attention deficit, immediate memory loss, fatigue, insomnia, depression, skin lesions on the hand holding a mobile phone.

  • Prevalence estimated by some experts at 3 - 5% of the population.

Ground (land) pollution and human health

• Primary biliary cirrhosis prevalence is higher in people living near Superfund toxic waste sites in New York City (Hepatology. 2006. 43. 525-531).

• Major categories of land pollutants include BPA, phthalates, pesticides and flame retardants.

Noise pollution and human health

• Constant low level noise (car and train traffic) is associated with higher release of cortisol while sleeping, based on research in 115 Australian children (J Acoustic Soc Amer. 3/01).

• May lower productivity and motivation, based on data in 40 clerical workers who made fewer attempts to solve a difficult puzzle when working in a noisy environment (J Applied Psychol. 10/00).

• Correlated with an increased risk of MI (Eur Heart J. 2/06). Men living for at least 10 years near streets with heavy traffic were 80% more likely to have a heart attack than those living on quiet streets.

• Noise from intermittent traffic disturbs sleep and worsens mood and performance the next day.

Water pollution and human health

• Consumer Reports tested the water supply of 120 people across the US, selected from a pool of more than 6,000 volunteers, and found PFAS (see section on PFAS below on this web page) at a concentration > 10 ppt in 46 samples of 120, lead at detectable levels in 118 samples (and this may have been due to lead in home pipes rather than in the public water supply in some instances), and arsenic levels > 3 ppb in 10 samples. Note that in contrast with the above limits, EPA sets an acceptable level of lead in public water supply as 15 ppb in > 10% of samples obtained, acceptable levels of arsenic at 10 ppb, and does not have a limit in 2021 for PFAS (Consumer Reports. May 2021. 34-43).

• The Clean Water Act of 1972 focuses on discharge of pollutants in navigable bodies of water or into surface water.

• The Safe Water Drinking Act (SWDA) of 1974 which addresses water designed for drinking, either groundwater or underground sources.

• Over 90 drinking water contaminants are recognized and regulated by the EPA, in 2019.

  • Categories of contaminants which are regulated by the EPA include (1) microorganisms, (2) disinfection byproducts [chlorine or other disinfectants reacting with organic matter to produce toxic chemicals], (3) heavy metals, (4) nutrient pollution [nitrate, nitrite], (5) pesticides and herbicides, and (6) radioactive material

  • Categories of contaminants which are NOT regulated by the EPA include (1) PFAS (see sections on PFOA and PFOS below in this outline), (2) microplastics, (3) pharmaceuticals, fracking-related contaminants, cyanotoxins from blue-green algae, perchlorate (rocket fuel), and 6PPD-quinone (from road tires).

• Note, even for categories of contaminants which are regulated, the EPA limit is sometimes significantly higher than the level recommended for protecting health - for many contaminants, lower limits are set by the Environmental Working Group at ewg.org/tapwater/ewg-standards.php.

• WHO data (2019)

  • 2 billion people use water contaminated with feces

  • 2.2 billion people do not have access to safe and readily available water on-premises

  • 206 million people travel up to a 30-minute round trip to an improved drinking-water service

Childhood diseases – the change in prevalence is indicative of a change in the environment

• ADHD diagnosed in 6% of school-age children in 1999 (AHCPR Research Publication 99-0050). There was no entry for ADHD in the American Association Psychiatric DSM until 1968.

• Asthma prevalence estimated at 9% in children and adolescents in 2005, double the prevalence in the 1980’s (Adv Data. 2006. 381. 1-24).

• Brain tumor incidence increased 21% between 1973 and 2003; lymphoma incidence increased 30%.

CATEGORIES OF POTENTIAL POLLUTANTS

Air fresheners 

• Most contain synthetic fragrances that may emit potentially dangerous phthalates and volatile organic compounds.

• Natural alternatives include a bowl filled with dried sage or thyme, or essential oils.

Air purifiers (Consumer Reports. May 2005. 22-25; Dec 2007. 48-51; Sept 2010. 44-46. August 2021. 21-25)

• Note according to the EPA, indoor air is 2-5 times more polluted than outdoor air on average.

• Not regulated by the EPA because they are used indoors, and not regulated in 2005 by the FDA because they are not considered medical devices.

• See Consumer Reports for top-ranked air purifiers.

• Types of air purifiers - avoid purchasing a type which generates ozone as a byproduct

  • HEPA – air purifiers equipped with a HEPA filter are able to absorb 99.7% of all particles that are 0.3 microns and larger in size. Most harmful particles found in the air are measured to be about 0.3 microns or larger. To qualify as a "true" HEPA, the filter must allow no more than 3 particles out of 10,000 to penetrate the filtration media.

    • This is the type of air purifier recommended by Consumer Reports.

    • Note though that pure HEPA air purifiers do not remove odors, chemicals or gasses, as these are molecular level substances smaller than 0.3 micron.

    • Limitation - because air must pass through the filter, it can be difficult to clean a very large room with a HEPA filter.

  • HEPA combined with a carbon filter (zeolite in the carbon serves as a molecular sieve and as a desiccant).

  • Electrostatic - use an electronic charge to attract particles to collection plates and eliminate them from the air. Most create some ozone, and thus not recommended by Consumer Reports.

    • One stage system

    • Two stage system

  • Ionizing – these use a charged plate electrostatic system, but with no fan. It relies solely on the electrostatic plates to move the air though the air purifier. As per Consumer Reports, these tend to produce more ozone than HEPA purifiers and thus not recommended.

  • Negative ion purifiers – new technology, but as per www.mercola.com (February 2006), not proven as effective as HEPA technology or electronic technology when it comes to eliminating and catching more particles in the air.

  • Ozone - there are ozone air purifiers on the market, but these absolutely should not be used (except by professionals after a fire or a flood), as per Dr. Mercola and Consumer Reports.

  • Photocatalysis – as per www.mercola.com (February 2006) photocatalysis is a process that oxidizes organic odors, germs, and fungi in a room or office -- exactly the same way this occurs in nature. The other part of the process is a catalyst made from Ti02 (titanium dioxide) and other proprietary metals, that when activated, generates hydroxyl radicals and super oxide ions. This system is not an air filter, but an air purifier duplicating nature's own methods of air cleaning and revitalization. Effectiveness uncertain - in 2021, the Molekule Air brand earned a poor overall score.

  • Ultraviolet germicidal irradiation - effectiveness limited as per Consumer Reports August 2021.

• Safety

  • The voluntary industry standard (Underwriters Laboratories) is that they do not produce more than 50 ppb ozone; many of them failed in this regard (Consumer Reports. 5/05. 22-25).

  • There is a growing consensus that 50 ppb is too high an acceptable level of ozone emissions (Consumer Reports. 12/07. 48-51).

  • Current methodology for measuring ozone emissions from air purifiers is far from perfect (Consumer Reports. 5/05. 12/07. 48-51)

• Effectiveness

  • CADR (clean-air-delivery-rate) results with a seal issued by AHAM (Association of Home Appliance Manufacturers) are meaningful as per Consumer Reports - values above 350 are excellent and below 100 are poor.

  • Seals of approval from AAFA (Asthma and Allergy Foundation of America) and Allergy UK can be deceiving - these may based only on truthfulness of the product claims, not clinical efficacy. They also may be based only on the models highest speeds (i.e. loudest).

  • Consider whole house models with a filter, especially if using a forced air heating/cooling system.

  • Portable air purifiers – bigger is better.

Asbestos

• A naturally occurring fibrous mineral found in housing insulation, drywall, artificial fireplace logs, and toys.

• Exposure is associated with mesothelioma, a form of lung cancer.

• Many manufacturers have reduced use but not banned by US government as of 2010.

Benzene

• Volatile gas in gasoline, motor vehicle exhaust, refined petroleum, and tobacco smoke.

• Greatest exposure occurs when filling up the car with gas at the service station.

• Exposure is linked to leukemia.

Bisphenol A (BPA) - AVOID. Note that replacement bisphenols, Bisphenol F and Bisphenol S are not necessarily safer than BPA.

• Note cinnamon may facilitate clearance of BPA from the body.

• This is a chemical used in plastic production since the 1940’s to harden polycarbamate plastics and make epoxy resins; BPA was "grandfathered in" in 1976 when Congress passed the Toxic Substances Control Act.

• CDC found BPA in the urine of 95% of 394 individuals tested (Environ Health Perspect. 2005. 113. 391-395); NHANES 2003-2004 found BPA in the urine of >90% of the US population (Environ Health Perspect. 2008. 116. 39-44). Similar results have been reported in Japan (Environ Health Prevent Med. 2007. 12. 258-264) and Italy (Environ Health Perspect. 2010. 118. 1603-1608).Primary route of exposure in humans is oral ingestion, but also some transdermal exposure and inhalation of BPA in dust.

  • Short half-life so reduction in exposure is effective at reducing body load (but exposure is often constant, and very small amounts in the blood have biological effects).

  • Enhancing glucuronidation via sulforaphane supplements or via increasing consumption of cruciferous vegetables will increase the rate of detoxification.

• Even though the EPA has set the lowest observed adverse effect level at 50mg/kg/day, a study showed effects of BPA on the testes, prostate, ovaries, and breast tissue at levels lower than 1 ppb (full report at www.endocrinedisruption.com/endocrine.TEDXList.overview.php).

  • Many academic investigators conclude that the acceptable daily intake of BPA should be 20,000 fold lower than the current estimated ‘safe’ dose (Vom Saal FS et al. Update on the Health Effects of Bisphenol A: Overwhelming Evidence of Harm. Endocrinology. 2021. 162. bqaa171).

• Found in many sturdy, hard plastic items, as it is present in epoxy resins lining food and beverage containers (often labeled at #7).

  • Common sources include (hard) water bottles, baby bottles, food containers (such as those labeled microwavable), canned food (it is in the resin lining the cans), utensils, carbonless paper used for receipts, compact discs, and dental sealants.

  • More than 2 million metric tons produced in 2003, with an annual increase in demand of 6-10% (Eur Chem News. 2003. 78. 17).

• Adverse health effects (Editorial. Ann Intern Med. 2011. 155. 392-393).

  • BPA is a xenoestrogen – while dose needed to stimulate breast cell cancer growth is 100,000 times higher than estradiol, there is some data that BPA acts similarly to the synthetic estrogen, DES. Furthermore, animal data shows that the active metabolite of BPA is more estrogenic than the parent compound.

  • BPA has antiandrogenic activity in men, and alters the ratio of estradiol to testosterone in a manner which indicates decreased aromatase activity in those men with exposure – data derived from single urine measurement of BPA and multiple serum hormone level measurements in 167 men recruited from infertility clinics (Environ Sci Technol. 2010. 44. 1458-1465).

  • Accumulating evidence indicates that BPA exposure (1) increases the risk of breast cancer and (2) can interfere with chemotherapy for breast cancer.

  • Cross sectional data in 1455 adults in NHANES 2003-2004 found that higher BPA exposure, as reflected by higher urinary concentrations of BPA-monoglucuronide, were correlated with an increased risk of cardiovascular disease, type II diabetes, and elevated liver enzymes (JAMA. 2008. 300. 1303-1310 and editorial 1353-1355).

  • As per a presentation by Joseph Pizzorno, ND (AIHM Environmental Medicine Update, October 29, 2021) bisphenol exposure is also correlated with lower IQ, increased incidence of asthma, depression, and male infertility.

  • The potential role for BPA in the pathogenesis of human obesity is controversial (in 2011).

  • BPA might contribute to nonfunctional adrenal incidentalomas (Endocrine. 2021. 71. 459-466).

• Products containing BPA were banned in San Francisco as per June 2006 city legislation.

• In November, 2006, 38 scientists met at Chapel Hill, with the meeting sponsored by the National Institute of Environmental Health Sciences (NIEHS). They reviewed more than 700 studies and concluded that the molecular mechanism of action in humans and animals is essentially identical, and that human and animal cells respond to similar doses of BPA. A consensus statement was issued (Saal F et al. Reprod Toxicol. Epub 7/27/07).

• Most claims for human safety are based on extrapolation from rodent-based toxicology models, but the relevance of this model to humans is unclear.

  • BPA may be safer in humans than rodents, as there is data the BPA glucuronide in humans is excreted in the urine, and thus not subject to enterohepatic recirculation, whereas BPA in rodents is excreted in the feces (Letter written by Exec Director American Dental Assn).

  • Nonetheless, a growing body of animal studies demonstrates neurological (i.e. inattention), reproductive (i.e. breast and prostate cancers), and metabolic abnormalities (i.e. diabetes, obesity) at very low levels of exposure, comparable to human exposures.

Cell phones

• First introduced in Japan in 1979. In the US, originally developed for the Department of Defense, and entered the marketplace in 1983 without testing for safety.

• Post-market evaluation now under the auspices of the FDA, not the EPA.

• Safety is not proven

  • The Interphone study, a 30 million dollar international research project about the potential risks of cell phones, was launched in 2000 and concluded in 2006 - controversy regarding design and data analysis, and thus many questions that remain unresolved.

  • In May 2011, the World Health Organization's IARC issued a report listing mobile phones as possible carcinogens based on limited evidence about associations with childhood leukemia - in the same category as lead and gasoline engine exhaust, although the Federal Communications Commission and the US Food and Drug Administration have maintained that they are safe

  • Possible health hazards are as follows:

    • Brain tumors

      • Meta-analysis of case control studies (465 articles identified; 23 studies met inclusion criteria, and these 23 studies included 12,344 patient cases and 25,572 controls) found that overall, use of cell phones was not associated with tumor development in a random effects model. However, a harmful effect was found in studies that blinded the interviewers to a history of cell phone use, and a harmful effect was found in the subgroup that used a cell phone for > 10 years, using a fixed effect analysis of the 13 studies that reported this association (Myung SK et al. J Clin Oncol. Epub 10/13/09).

      • INTERPHONE study found an increased risk for glioma among adults with heavy cell phone use (cumulative duration of 1640 hours or more). Study limited by recall bias and methodologic issues (Occup Environ Med. 2011. 68. 631-640).

      • A study in Sweden concluded astrocytoma 5 times more common among adults who first used cell phones before age 20 (Int J Oncol. 2011. 38. 1465-1474).

      • CEFALO, a multi-center case-control study reported “No increased risk of brain tumors was observed (in children) for the brain areas receiving the highest amount of exposure (Aydin D et al. J Natl Cancer Inst. E pub 7/27/11). A critique of this study was written by the Environmental Health Trust (www.environmentalhealthtrust.org).

    • Behavioral problems – a survey of 13,159 Danish children found an 80% increased risk for hyperactivity and emotional problems amongst young children who used cell phones and whose mothers also used cell phones during pregnancy (Epidemiology. 2008. 19. 523-529).

    • Infertility – the evidence that RF EMF from cell phones affects sperm quality and quantity in animals and in humans is compelling (PLoS One. 2009. 4. e6446); unknown in 2010 is whether this translates into declines in actual human fertility. Data is suggestive of an adverse effect on fertility, with multiple references provided in the following article (Male infertility linked to cell phone EMF exposure. Holistic Primary Care. Summer 2011).

    • Migraines and vertigo – in a Danish retrospective study, long term cell phone users 10-20% more likely to be hospitalized for migraines and vertigo than people who began to use cell phones more recently (PLoS One. 2009. 4. e4389).

    • Miscarriages – suggestive data (Male infertility linked to cell phone EMF exposure. Holistic Primary Care. Summer 2011).

    • Neurodegenerative disease – theoretical mechanism and anecdotes.

    • Parotid salivary gland tumors – in a nationwide case control study, positive association identified (Am J Epidemiol. 2008. 167. 457-462).

  • Cell phone radiofrequency exposure affects brain glucose metabolism – in a randomized, crossover study in 47 healthy participants, “50-minute cell phone exposure was associated with increased brain glucose metabolism in the region closest to the antenna. This finding is of unknown clinical significance” (JAMA. 2011. 305. 808-814 and editorial 828-829).

• Ways to minimize the risk – scroll down on this page to Practical measures to decrease the exposure… and then scroll down to ‘cell phones.’

• Cell Phones: Invisible Hazards in a Wireless Age. George Carlo, PhD, JD. 2001.

• Disconnect - dangers of cell phones for children. Devra Davis, PhD. 2010.

• The Hidden Dangers of Cell Phone Radiation. Life Extension. Sue Kovach. 8/07.

• Safe Wireless Initiative www.safewireless.org to disseminate information on dangers

• Mobile Telephone Health Concerns Registry www.health-concerns.org to voluntarily track information provided by users who believe they are experiencing adverse health effects.

• Ranking of cell phones by how much radiation each emits www.ewg.org/cellphone-radiation

Cleaning Products

• Terms such as ‘natural,’ ‘environmentally friendly,’ and ‘nontoxic’ lack standard definitions (Consumer Reports. 1/08. 6).

• Certified biodegradable is a term that is independently verified (Consumer Reports. 1/08. 6).

• The Leaping Bunny symbol (present on Earth Friendly and Seventh Generation detergents) is independently verified and means that the product has not been tested on animals (Consumer Reports. 1/08. 6).

Construction – LEED (Leadership in Energy and Environmental Design) standards – certified, silver, gold, platinum

DECA

• Flame retardant found in electronics, furniture, carpets

• Adverse health effects include permanent learning and memory deficits, hearing defects, and decreased sperm count in animals.

• Industry began phasing out use of this chemical in 2009, upon advice of EPA.

DEET (Consumer Reports on Health. June 2014. Page 10)

• First used by US army and sold to consumers since the 1950s.

• Highly effective

• Safety - a December 2013 analysis of 4000 DEET-related calls to poison control centers found that 450 individuals required medical treatment after applying DEET, and 2 died.

• Risk seems increased in products with 95% DEET or more, seems less in products with 30% deet or less, and testing suggests that products with as little as 15% DEET are effective.

Deodorants (Natural Solutions. Auguste, 2008. Pgs 36-39)

• As opposed to soaps and shampoos, these cosmetics are not rinsed off, so the chemicals accumulate in the underarm and upper breast.

• Aluminum compounds, found only in antiperspirants, may be absorbed and increase body aluminum levels to an undesirable range.

• Propylene glycol, a penetration enhancer found in many ‘natural’ deodorants too, functions as a penetration enhancer – it can cause skin irritation and can be harmful when combined with other chemicals.

• Triclosan, an antibacterial agent, combines with the chlorine in tap water to form chloroform gas, a potential toxin.

• Steareths are byproducts of a manufacturing process (ethoxylation) that makes harsh ingredients more mild. This same manufacturing process produces carcinogenic 1,4 dioxanes.

• Safe alternatives – see below in this outline ‘Practical Measures to Decrease Exposure…’

• When switching to a safer deodorant, realize that it may take the body a week to readjust, with increased body odor for the transition period. If transitioning from an antiperspirant, dry brushing the underarms with a dry washcloth, and also applying a hot washcloth for a few minutes a day, followed by scrubbing with natural soap, may help to get the glands and pores functioning again.

Dioxins

• Family of chlorinated compounds produced as a by-product of industrial processes.

  • Municipal and medical waste incineration

  • Production of vinyl and PVC

  • Copper smelting

  • Chlorine pulp and paper bleaching

• Routes of exposure – ground deposition; can travel 1000 miles from incineration sites.

• Bioaccumulate in fatty tissue; highest levels are found in breast milk.

• Found in beef, pork, dairy products, fish, with extremely high levels in canned meat baby food

Dry cleaning (Consumer Reports. February 2003. Pg 10)

• Traditional processes use a cleaning agent called perchloroethylene (perc), which is a carcinogen in animals and may be a carcinogen in humans. Exposure to perc vapors can cause dizziness, fatigue, headaches, and memory loss. Removing clothes from the plastic bag and letting them air out in the garage minimizes exposure to perc.

• Alternatives to perc

  • Carbon dioxide - better results than even conventional dry cleaning. www.hangersdrycleaners.com for locations

  • Silicone-based - marketed as Green-Earth cleaning, and results comparable to conventional dry cleaning. www.greenearthcleaning.com for locations.

  • Wet-cleaning - recommended by GreenPeace, but results poor, so consider only for clothing you would consider hand-washing.

Food production (The Omnivore’s Dilemma by Michael Pollan)

• History

  • 1909 – Fritz Haber, a German chemist, figured out how to “fix” nitrogen, making it useful to living things. Prior to this, all usable nitrogen on earth had been “fixed” by soil bacteria living on the roots of legumes, or by lightning strikes (Pg 42).

  • 1947 – there was a huge surplus of ammonium nitrate used during WWII for explosives. The USDA recommended spreading this on farmland as fertilizer to use up the surplus, and subsequently munitions plants switched to producing chemical fertilizer. “The chemical fertilizer industry (along with that of pesticides, which are based on poison gases developed for the war) is the product of the government’s effort to convert its war machine to peacetime purposes.” (Pg 41)

  • US farm policy in the 1930s sought to avert overproduction (Pg 49). This policy gradually began to change between the 1950s and the 1970s (Pg 50), then changed significantly with the 1973 farm bill which began a system of payments to farmers to subsidize production, in place of incentives to avert overproduction (Pg 52).

  • Replacement of the family farm with CAFOS (concentrated animal feedlot operations).

  • These generate an estimated 575 billion pounds of animal manure yearly, which cannot economically be transported any significant distance, so is stored in lagoons or covered pits, and may contaminate nearby streams and rivers.

  • Antibiotic overuse is a common feature of these operations.

• Petroleum is the source of synthetic fertilizer

  • “One fifty of America’s petroleum consumption goes to producing and transporting our food” (Pg 83)

  • It requires about 50 gallons of oil to raise one acre of corn – this includes the natural gas which is the source of synthetic fertilizer, the fossil fuels used to synthesize the pesticides, and the gas used to plant, harvest, and transport the corn (Pg 45).

  • A 1200 pound steer which eats 25 pounds of corn per day will have consumed in a lifetime the equivalent of 35 gallons of oil (Pg 84).

• Farmers have an economic incentive to use excess synthetic fertilizer to increase yield of corn, and the excess either evaporates and contributes to acid rain, or ends up in streams and rivers, and eventually most of it ends up in the Gulf of Mexico, where its “deadly fertility poisons the marine ecosystem” (pg 47) creating “an eight-thousand-square-mile zone so starved of oxygen nothing but algae can live in it” (Pg 83)

• “…as much as a third of all the greenhouse gasses that human activity has added to the atmosphere can be attributed to the saw and the plough.” (Pg 198)

• “…if the sixteen acres now being used to grow corn to feed cows in the United States became well-managed pasture, that would remove fourteen billion pounds of carbon from the atmosphere each year, the equivalent of taking four million cars of the road.” (Pg 198)

• “It’s true that prodigious amounts of food energy are wasted every time an animal eats another animal – nine calories for everyone we consume. But if all that energy has been drawn from the boundless storehouse of the sun, as in the case of eating meat off this pasture, that meal comes as close to a free lunch as we can hope to get. Instead of mining the soil, such a meal builds more of it. Instead of diminishing the world, it has added to it.” (Pg 199)

• “…researchers at the Land Institute have … calculated that in fact more nutrients are produced – protein and carbohydrate – in an acre of well-managed pasture than in an acre of corn.” (Pg 199)

• “… the government did everything it could to help wean cattle off grass and onto corn, by subsidizing the building of feedlots (through tax breaks) and promoting a [USDA] grading system based on marbling that favored corn-fed over grass-fed beef. (The government also declined to make CAFOs [concentrated animal feeding operations] obey clean air and water laws).” (Pg 200)

• “The ninety-nine-cent price of a fast food hamburger simply doesn’t take account of that meal’s true cost – to soil, oil, public health, the public purse… costs … to the taxpayer (in the form of subsidies), the health care system (in the form of food-borne illnesses and obesity), and the environment (in the form of pollution)…” (Pgs 200-201)

• Efficiency – two different definitions (Pgs 214-215)

  • Industrial agriculture – yield of one chosen species (monoculture) per acre

  • Natural systems – efficiencies flow from complexity and interdependence. One creature’s waste becomes another creature’s lunch. Efficiencies come from mimicking relationships found in nature, and layering farm enterprises on the same land over time. In effect, farming on a plot of land is in 4 dimensions, space and time.

• Flaws in the argument that many individuals in the U.S. cannot afford to buy organic food and food raised on a sustainable farm because it is too expensive.

  • With food raised on a sustainable farm “…all of the costs are figured into the price. Society is not bearing the cost of water pollution, of antibiotic resistance, of food-borne illnesses, of crop subsidies, of subsidized oil and water – all of the hidden costs to the environment and the taxpayer that make cheap food seem cheap.” (Pg 243)

  • As a society, Americans spend about a tenth “…of our disposable income feeding ourselves…down from a fifth in the 1950s. Americans today spend less on food, as a percentage of disposable income, than any other industrialized nation, and probably less than any people in the history of the world.” (Pg 243)

Formaldehyde

• Occupational exposure to formaldehyde (in manufacturing or in funeral industry) associated with increased death rates from myeloid leukemia (J NCI. 2009. 101. 751-761 and 1696-1708).

• Widely used in construction materials, manufacturing, consumer products, and in funeral industry.

Glyphosate (Roundup®)

Campbell AW. Altern Ther Health Med. 2014. 20[3]. 9-11; Gale R and Null G. Townsend Letter. May 2016. 36-43; Hamilton D. Townsend Letter. April 2020. 32-34.

• Most widely used herbicide in the world (Pest Manag Sci. 2000. 56. 299-308).

  • 1.5 billion pounds used in 160 countries in 2016, as per Monsanto website.

  • US is world's largest consumer, using approximately 20% of the world's Roundup. US Geological Service record shows that 280 million pounds of Roundup were used in the US in 2012

• While Roundup is the most popular form of glyphosate, glyphosate is present in over 750 products sold in the US.

• Originally patented as a chelating agent, wetting agent, and biologically active compound used as a descaling agent to clean out mineral deposits in plumbing pipes, boilers, and heaters (patented in the US in 1964 for these indications); later patented as a herbicide and marketed under the name of Roundup® by Monsanto in 1974.

• Uses

  • Herbicide, including genetically modified crops which are modified to be resistant to the effects of Roundup - soy (since 1996), corn, cotton, canola, sugar beets and alfalfa.

  • Drying agent - sprayed on wheat before harvest to hasten the drying process.

• Nonselective herbicide - works by blocking the shikimate pathway which exists in plants, bacteria, and yeast, but not in animals.

• While glyphosate does not directly damage human tissue

  • It damages the human GI microbiome and via this mechanism inhibits microbial production of tyrosine and tryptophan, the amino acid building blocks of neurotransmitters, as well as inhibiting microbial production of methionine, a critical source of sulfur in the body.

  • It is a chelating agent and can cause mineral deficiency or insufficiency in humans via chelation of minerals.

  • It interferes with the human cytochrome P450 enzymes.

  • It destroys tight junctions in between the endothelial cells of the gut, causing leaky gut.

  • It may enhance the bioavailability of aluminum

• Historically considered safe because it is water soluble and thought to be readily degraded into a nontoxic degradation product. HOWEVER,

  • Detectable in the urine of farm workers, and residues detectable in many foods.

  • Recent studies have demonstrated toxicity, including DNA damage (Arch Toxicol. 2012. 86. 805-813), disrupts aromatase (Environ Health Perspect. 2005. 113. 716-720), suppresses CYP 450 enzymes and amino acid synthesis by the gut microbiome (Entropy. 2013. 15. 1416-1463), and may cause toxic nephropathy (Int J Environ Res Public Health. 2014. 11. 2125-2147).

  • In 2015, classified as a carcinogen by WHO International Agency for Research on Cancer and by State of California OEHHA.

  • May be contributing to an increase in chronic disease, including Alzheimer's, Parkinson's, and autism (Entropy. 2013. 15. 1416-1463).

  • Of particular concern, there is suggestive animal data that low doses may be as toxic as higher doses (Environ Health. 2015. 14. 70).

  • Independent review of the toxicity data from Monsanto's internal scientific and toxicologic data raises concerns (Samsell A and Seneff S. J Biol Phys Chem. 2015. 15. 121-159).

• Supplements which may be beneficial to counteract glyphosate exposure (Hamilton D. Townsend Letter. April 2020. 32-34)

  • Dandelion can protect the liver

  • Fulvic acid - if taken as a supplement, is absorbed into the blood stream and may bind glyphosate in the blood

  • Humic acid adsorbs glyphosate and may facilitate elimination in the stool

  • Quercitin may protect detoxification enzymes

  • Silica can bind aluminum in the GI tract, offsetting the glyphosate-induced increased bioavailability

  • Taurine can promote bile flow

  • Vitamin C can counteract some of the oxidative stress caused by glyphosate

Heavy (toxic) metals

• 35 metals are of concern due to occupational or residential exposure to potentially toxic doses

  • 23 of these are "heavy metals": antimony, arsenic, bismuth, cadmium, cerium, chromium, cobalt, copper, gallium, gold, iron, lead, manganese, mercury, nickel, platinum, silver, tellurium, thallium, tin, uranium, vanadium, and zinc.

  • "Heavy metals" are defined as chemical elements with a specific gravity at least 5 times the specific gravity of water.

• In small amounts, some of these metals are common in our environment and diet, and even necessary for health.

  • Copper, iron, manganese, and zinc are heavy metals which are necessary for life – they are referred to as trace elements.

  • Mercury occurs naturally in the crust of the earth; ~50% of environmental mercury is ‘natural’ in origin and ~50% is released from human activities (coal-fired plants, waste incineration, dental industry).

• Heavy metal toxicity can result in damage to the nervous system, cardiovascular, hematopoietic, immune system, lungs, kidneys, brain, liver, other vital organs, and cancer.

• Long-term exposure may result in slowly progressing physical, muscular, and neurological degenerative processes that mimic Alzheimer's disease, Parkinson's disease, muscular dystrophy, and multiple sclerosis.

• Ways to reduce exposure to heavy metals – see ‘Practical Measures’ below

Insect repellants – see DEET

Light bulbs

• Compact fluorescent light bulbs (CFLs) use 75% less energy and last 6-10 times longer.

  • The downside is that they do contain a trace of mercury. HOWEVER, the major source of mercury in the environment today is coal-fired power plants, so by reducing the demand for electrical power from coal-fired power plants, fluorescent bulbs actually may decrease the environmental burden caused by mercury (Janet Brown. Holistic Primary Care. Winter 2007).

  • Due to the mercury content, it is best to discard fluorescent bulbs as hazardous waste, rather than in the trash – go to www.epa.gov/bulbrecycling.htm for a recycling site near home. As of 2011, Home Depot, Ikea, Lowe’s, and some Ace and True Value stores allow consumers to drop off used bulbs for recycling.

  • If the bulb breaks, open a window, leave the room for 10 minutes, wear disposable gloves, brush the broken pieces into a sealable plastic bag, wipe up using a damp paper towel, and put plastic bag in the trash. Don’t vacuum, as this can disperse the mercury. More information at www.epa.gov/mercury/spills.

  • Some bulbs produce a yellow light (labeled ‘soft’ or ‘warm’) whereas some produce a white light (labeled ‘bright white’ or ‘natural’ or ‘daylight’).

  • Potential safety issues with CFLs

• Most light bulbs contain ~1% of the amount of mercury in a mercury thermometer - www.gghc.org provides information on the mercury content of different brands, as the content does vary from brand to brand.

• All fluorescent bulbs “flicker.” The flicker is not visible, but with AC voltage, the luminance of the bulb changes 120 times per second, fluctuating between full light output and total darkness 120 times per second. This fluctuation creates an electromagnetic field, and the effect of this electromagnetic field on human physiology is unknown. A 10 watt fluorescent tube may produce a magnetic field at least 20 times greater than a 60 watt incandescent bulb (Wikipedia).

• Light emitting diode bulbs (LEDs) contain no mercury and use less energy than CFLs, and have an estimated 18-46 year life span. EXPENSIVE in 2011.

• Products (Time 8/3/09 and extensive ratings Consumer Reports 10/10 pg 29)

  • Lennis’ Pharox LED – lifetime of 25 years, cost of $50 per bulb

  • Earthmate’s Super Mini-Size CFL – contains 80% less mercury than standard CFLs, lifetime of 10,000 hours, cost of $3.50 per bulb

  • Philips’ T60 Halogena is an incandescent which uses 30% less energy than traditional incandescents, lifetime of 3000 hours, $5 per bulb

Medical Waste

• Medical waste incineration was the single largest source of dioxin air pollution.

• In 1997 medical waste incinerators were the fourth largest source of man-made mercury emissions.

• Hospitals also contribute to mercury in the water supply and landfills (mercury thermometers, mercury BP cuffs, fluorescent lights)

• In 2005, over 6000 medical waste incinerators have shut down, and mercury emissions from medical waste incinerators has been reduced by 99%!

• Hospitals for a Healthy Environment (H2E) was formed in 1998 when the EPA and American Hospital Association (AHA) signed a Memorandum of Understanding to address serious environmental issues. The group is now a collaborative effort between the EPA, AHA, American Nurses Association, and nonprofit coalition Health Care without Harm (www.noharm.org).

Medication

• Trace levels of multiple medications are now measurable in municipal water supplies - repercussions in terms of human health, in particular with regard to antibiotics and estrogenic medications are uncertain.

• Federal guidelines for drug disposal suggest mixing unused medication with coffee grounds or cat litter, placing in a sealed container, and throwing out with the trash (except for some controlled substances, which the government still recommends flushing down the toilet, as of 2008).

• Some pharmacies have take-back programs for unused medications.

Menstrual Hygiene products

• Sanitary pads and tampons have significant plastic content, and contribute to solid waste.

• Menstrual cup - see section at the bottom of this outline, entitled Practical measures to reduce waste and decrease the exposure to environmental toxins/EMF pollution

Microbeads - see Plastic - Microplastics below

Mold

• Mycotoxins can overload detoxification mechanisms in the liver, affect the immune and nervous systems, and lead to multiple chemical sensitivities.

• Trichothecenes are a very bad group of mold toxins.

• If mold in the home is suspected as the cause of symptoms, leave the home for 5 days and acquire new clothing not washed in the home, to see if symptoms improve.

Nanotechnology (Consumer Reports. Investigative Report. 7/07. 40-45)

• This involves technology which reduces particles to nanometers in size, and it does offer tremendous potential in the areas of (1) health and medicine, (2) energy and the environment, and (3) consumer products.

• The characteristics of materials changes at the nanoscale benign materials can become toxic, because microscopic particles may react more readily with human tissue.

• There is concern that nanomaterials may linger in the environment and damage the ecosystem.

• Traditional safety assessment methods are not adequate for nanomaterials; very little money has been spent on risk assessment.

• In 2007, the FDA is not involved in assessment of nanoingredients, and labeling of products which have nanoingredients is not mandatory.

• Even though there is no mandate to disclose whether a consumer good has nanoparticles in it, the Project on Emerging Nanotechnologies maintains a database of hundreds of nano-based products ranging from socks to car wax – www.nanotechproject.org/inventories/consumer.

Oxybenzone

• Chemical used in cosmetics, found in sunscreen, lip balm, moisturizers.

• Potential health hazards include hormone disruption and low-birthweight babies.

Ozone

• In the upper atmosphere ozone is good - it shields us from harmful ultraviolet rays.

• In the air we breathe, ozone is a free radical and an irritant detrimental to human health.

• EPA standard for outdoor air is less than 80 ppb averaged over 8 hours; there is no EPA standard for indoor air.

• A recent study has shown a link between death rates and average ozone concentration, even below 80 ppb.

• Asthmatic children have been shown to experience worse symptoms and require more rescue medication as a function of ozone levels between 60-80 ppb.

Parabens

• Synthetic preservatives found in personal care products and cosmetics (moisturizers, shaving products, deodorants, toothpaste, shampoo, conditioners, makeup)

• Causes hormone disruption and cancer in animals.

• Banned from personal care products in 2012 by the European Union, still in personal care products in the U.S. in 2019.

PBDEs (polybrominated diphenyl ethers) – part of a class of brominated flame retardants (BFRs)

• Levels of PBDE flame retardant in U.S. blood samples have risen sharply over the past three decades, based on measurement in frozen 1973 samples (J Occup Environ Med. 2005. 47. 199-211).

  • Blood levels of flame retardant are higher in the U.S. than any other country.

  • The greatest source of exposure (80%) is from house dust due to product aging and breakdown.

• Potential effects on human health are unknown; toxicological studies show that these compounds are neurotoxins, carcinogens, and endocrine disruptors.

• PDBEs have properties similar to PCBs and dioxins.

• PDBEs are found in fabrics, upholstery foam, carpets, insulating material, and electronic devices

• Countries that have banned synthetic flame retardants have noted falling levels in humans.

• Ikea furniture and mattresses don’t contain PDBE’s

Pesticides - see section on POPs just below

PFAS (perfluoroalkyl and polyfluoroalkyl substances) [Consumer Reports. November 2020. Pages 28-33 and May/June 2023. 52-59; Pizzorno J. Editorial. Integrative Medicine. 2024 22[6]. 12-15]

• More than 12,000 known substances in this class, each with a carbon chain of varying length that is either fully or partially saturated with fluorine atoms and has a polar end group.

  • These compounds have very long half life (2-7 years) in terms of degradation, are difficult to excrete, and thus accumulate in the body.

  • The rate of detoxification in the body is generally inversely proportional to the number of fluorine substitutes.

  • Classified according to chain length

    • Long-chain: 6-7 or more perfluorocarbons

    • Short-chain: 3-7 perfluorocarbons

    • Ultrashort-chain: 2-3 or fewer perfluorocarbons. These are water-soluble degradation products of the longer chain PFAS; commercial laboratories in 2023 do not measure these

• The greatest sources of exposure in the US are drinking water, prepared foods, and food packaging. PFAS are extremely high in microwave popcorn.

• Routes of exposure are food, water, clothing, dust, and industrial processes.

• PFAS are used in many consumer products to make them resistant to water, oil, stains, heat, and corrosion - sources include nonstick cookware, fast food greaseproof packaging and stain resistant clothing/carpeting/furniture.

• PFAS have been detected in the drinking water of more than 2337 communities in 49 states (January 2021, as per Environmental Working Group, as cited in Consumer Reports. May 2021). NOTE this category of chemical in the water supply is not regulated by the EPA (Consumer Reports. November 2020. Pages 28-33).

  • To have water tested for PFAS, click here to find an EPA-certified lab

  • Testing for PFAS in water is likely to cost $300 - $400, and tests for only a few of the thousands of PFAS

• CDC in 2022 reports four PFAS (PFOS, PFOA, PFHxS, and PFNA) in the serum of nearly all people tested (CDC website)

• Testing for PFAS in food or packaging is challenging, as there are thousands of PFAS; in 2023, technology exists to measure/quantitate only approximately 100 of the thousands - measurement of organic fluorine is considered a proxy for PFAS in food or packaging; California in 2023 is restricting the level of organic fluorine in food packaging to 100 ppm (Denmark recently set a limit of 20 ppm).

• NOTE the EPA in April 2024 announced a regulation (final rule) to require municipal water systems by 2027 to test for and if present, remove 5 specific PFAS - PFOA, PFOS, PFNA, PFHxS, and HFPO-DA (also known as “GenX Chemicals”). EPA estimates that between about 6% and 10% of the 66,000 public drinking water systems subject to this rule may have to take action to reduce PFAS to meet these new standards (Buffalo News. 4/11/24 and 4/12/24; EPA website updated 4/10/24).

• Assessment of body load is very difficult (in 2023).

• Two of the most studied compounds in this class are PFOA and PFOS.

  • PFOA is a component of Teflon found in nonstick pots and pans (PFOA are use to make the nonstick coating called PTFE); human studies show evidence of hormone disruption and reproductive abnormalities.

  • PFOA banned in approximately 2013.

• Risks/harms of PFAS (Pizzorno J [Editorial]. Integrative Medicine. January 2024. 22 [6]. 6-10) - definitive data is limited in 2024, for the following reasons

  • The mechanisms of damage are poorly understood

  • Most of the safety research is done with animals, but rodents detoxify PFAS 10-100 times faster than humans, so the relevance of rodent data to humans is uncertain.

  • Virtually all existing research in 2024 is on short-, medium-, and long-length perfluorinated compounds, but emerging research suggests that the ultrashort perfluorinated compounds are the worst for human health. Concentrations of the ultrashort compounds and water are typically 100 times higher than the concentrations of the longer chain compounds.

  • Human exposure has shifted over the past decade from PFOA, which was banned, to supposedly safer PFOS.

  • Exposure is so widespread and persistent that there is virtually no human control population.

  • There are many disease associations, but in 2024, likely due to to the challenges of conducting research (listed just above) many of the disease associations are of marginal statistical significance.

PFCs (perfluorochemicals)

• Very resistant to degradation; carcinogenic in animals

• Found in carpeting, clothing, and furniture labeled as stain resistant

• Found in non-stick cooking pans and some waxed dental floss

• Found in some cosmetics, such as nail polish, eye makeup and facial moisturizers.

PFOA - see PFAS just above

Phthalates - one of many chemicals in plastics; phthalates make plastic more flexible (they are plasticizers)

• Sources of phthalates – average daily intake estimated at 3 mg.

  • Children’s toys and children’s care products (i.e. infant formula, pacifiers) - several banned in legislation enacted 8/08

  • Clothing – polyester is plastic

  • Dental materials (i.e. composite fillings, crowns)

  • Food (Consumer Reports. February 2024. Pages 24-31).

  • Food packaging (water bottles, plastic food wraps) – there is data that the phthalates actually migrate from the plastic wrap or plastic bottles or Styrofoam cups into the food or water, and are thus consumed

  • Household items- particle board, plywood, polyurethane foam in furniture and pillows, Styrofoam cups, Teflon pans, vinyl floors, vinyl in shower curtains

  • Intravenous lines and bags

  • Medications - may be present in as many as 47 medications; phthalate metabolite levels higher in people taking didanosine (for HIV), mesalamine (for IBD), omeprazole (for GERD) and theophylline (for asthma)

  • Nail polish, cosmetic products, body lotions and gels, shampoos, deodorants, glues, detergents, insect repellents

  • PVC pipe

• Effects of phthalates in humans

  • Endocrine disruptors - phthalates found in the serum of 68% of girls with premature breast development and in 3% of age-matched controls (Environ Health Perspect. 2000. 108. 895-900).

  • Lower testosterone

  • Lower thyroid activity (but do not alter lab test values).

  • Increase cell proliferation in breast cancer tissue and inhibit tamoxifen-induced apoptosis (J Toxicol Environ Health. 2004. 67. 2025-2035)

  • Poison peroxisome proliferator-activated receptors (PPARs), which are nuclear receptors that are lipid-activated and control genes for metabolism, lipid homeostasis, inflammation, immune function, amongst other functions.

  • Predispose to atherosclerosis – a study in which 1016 participants, all age 70, underwent carotid ultrasound and had blood levels measured for BPA and 10 phthalates showed that the phthalate metabolite MMP was related to atherosclerotic plaques in the carotid arteries, independent of conventional CV risk factors (Atherosclerosis. 2011. 218. 207-213).

• Detoxification of phthalates (Note phthalates have a short half-life so reduction in exposure is effective at reducing body load)

  • Chelation is ineffective.

  • Sweat (sauna too) is the only proven mechanism for removing phthalates

  • Probably eliminated via glucuronidation pathway (Phase II) and this can be supported by intake of indoles (cruciferous vegetables) and calcium-D-glucarate.

Plastic (Special Report. Consumer Reports. June 2020. 27-35; Editorial. New Engl J Med. 2024. 390. 948-950. Time. July 5, 2024. 38-45).)

• See sections above on ‘Bisphenol A’ and ‘Phthalates’

• Plastics are manufactured chemical materials composed of a polymer matrix with chemical additives

  • Most plastic is manufactured from fossil fuels (gas, oil, coal).

  • As per Time magazine, in March 2024 team of European scientist published a database of more than 16,000 chemicals found in plastics, and estimated that only a quarter of the 16,000 chemicals have been tested for health impacts, with most of those which were tested found hazardous to human health.

  • Worldwide production of plastics has increased from less than 2 million tons in 1950 to approximately 400 million tons in 2020, and is projected to double by 2040. Approximately 40% of production in 2020 is disposable single-use items. In 2024, the industry is worth $712 billion a year, as per Time magazine.

  • The Minderoo Monaco Commission concluded that plastics endanger human health at every stage of the life cycle (Ann Global Health. 2023. 89. 23).

• NOTE the numbers (1-7) on plastic food and personal care product containers are resin ID codes for sorting for recycling, and don’t always correlate with the type of plastic in the product; #7 means ‘other plastics’ and includes products with the harmful BPA as well as products with less harmful plastics. For detailed information on relative safety of various types of plastic food containers, see the lengthy section below in this outline with the header 'Practical measures to reduce waste and decrease the exposure to environmental toxins’ and scroll down to the section ‘Safety of food containers as a function of the recycling code on the container.’

  • #1 (PET or PETE) - peanut butter plastic containers, soft drink plastic bottles, water bottles

  • #2 (HDPE) - milk and water bottles, detergent and shampoo bottles

  • #3 (PVC) - plastic wraps for grocery store food, plastic squeeze bottles, vinyl pipes, shower curtains

  • #4 (LDPE) - solid containers and food wrap

  • #5 (PP) - prescription bottles, syrup bottles and yogurt containers

  • #6 (PS) - foam containers and cups, disposable silverware, some clear disposable takeout containers, some plastic cups

  • #7 (other) - sports drinks, large water jugs

• Categories of plastics

  • Thermoplastics – soft when heated, harden when cooled. AVOID, as this category emits toxic vapors. Examples of thermoplastics – vinyl chloride, PVC, acrylic plastics

  • Thermosets – begin as soft plastics; when heated, shape is set. Safer than thermoplastics, as they don’t off-gas. Exceptions are urea-formaldehyde used in building materials, and polyurethane foam used in furniture and pillows.

  • Microplastics (also sometimes referred to as microbeads) - breakdown product of plastic, defined as polymer fragments between 0.1 um and 5 mm in size; enter the human body through ingestion, inhalation and skin exposure

    • Byproducts of plastic production (in facial cleaners, soaps, cosmetics, and toothpaste); also result from gradual breakdown of plastic

    • If microbeads are in a product, words such as polyethylene or polypropylene will appear in the ingredients list.

    • They are too small to be captured by sewage treatment plants.

    • Estimated in 2014 that there were between 15 trillion and 51 trillion individual bits of microplastics in the oceans, weighing 93,000 - 236,000 metric tons. The beads are eaten by fish and wildlife, and cause harm.

    • They do not decay, and accumulate toxins on their surface.

    • They may disrupt cell membranes, disrupt the microbiome, increase oxidative stress, trigger apoptosis, and alter immune system function (Danopoulos E et al. J Hazardous Materials. 2022)

    • Research in 2022 into certain bacterial strains that could potentially digest microplastics, removing them from the environment.

  • Nanoplastics - breakdown product of plastic, enter the human body through ingestion, inhalation and skin exposure. Defined as polymer fragments less than 0.1 um in size,

• Plastic and recycling (Consumer Reports. October 2021. 44-49)

  • Only #1 and #2 plastic are easily recycled; #3 - #7 typically in the US in 2021 are incinerated or placed in a landfill, as cost of recycling is high

  • As per the EPA, in 2018, only 8.7% of plastic waste (35 million metric tons) was actually recycled

POPs (Persistent Organic Pollutants) [Editorial. Pizzorno J. IMCJ. 2013. 12[2]. 8-10)

• Definition – “organic compounds that are resistant to environmental degradation through chemical, biological, and photolytic processes.” Resistance to breakdown results in bioaccumulation in humans and in animal food chains.

• Categories – industrial chemicals, pesticides, plasticizers, solvents.

• Dirty Dozen POPs (WHO – 1995) – Aldrin, chlordane, DDT, dieldrin, heptachlor, hexachlorobenzene, mirex, polychlorinated biphenyls, polychlorinated dipenzo-p-dioxins, polychlorinated dipenzofurantoins, and toxaphene. Since then, additions to the “dirty dozen” include carcinogenic polycyclic aromatic hydrocarbons, brominated flame retardants, and some organometallic compounds.

• Pesticides and human exposure

  • Worldwide pesticide usage is estimated at 6 billion pounds for 2012, with herbicides being the largest expenditure.

  • Glyphosate is an herbicide - see separate section on Glyphosate just above

  • Pesticide poisoning from drift exposure and soil fumigation, which causes very large amounts of drift, are major concerns, not only for agricultural workers, but also for adjacent homes, families, communities, and schools.

• POPs and diabetes - a nested case control study showed that those in only the second quartile of PCB 153 blood levels had 2.5 times the risk of diabetes, as compared with those whose levels were nondetectable (Environ Health Perspectives. 2010. 118. 1235-1242).

• A study of 37 pesticides in use currently examined which of these demonstrated in vitro androgen receptor antagonism. All 14 pesticides with previous evidence of androgen receptor antagonism were confirmed as antiandrogenic, as were 9 previously untested pesticides. In addition, 7 compounds were classified as androgenic (Environ Health Perspect. 2011. 119. 794-800).

• Pesticides and cancer – “a growing body of epidemiological, molecular biology, and toxicological evidence assessing the link … between specific pesticides and specific cancers is becoming available in the scientific literature.” The link is present for those applying the pesticides as well as those exposed to the pesticides. Data shows a link with breast cancer, prostate cancer, leukemia, multiple myeloma, and non-Hodgkin lymphoma (CA Cancer J Clin. 2013. 63. 120-142).

• Pesticides and diabetes - organic food has lower levels of pesticides and herbicides; data from NHANES 2007-2010 shows that the odds ratio of those who purchased organic food in the previous month was 0.80, meaning a diagnosis of diabetes was 20% less likely (Nutrients. 2018. 10. 1877).Chemical characteristics of POPs

  • Low water solubility

  • High lipid solubility

  • Semivolatility

  • High molecular masses (those with lower masses are less toxic)

  • Frequently halogenated – the more chlorine groups, the more resistant to degradation

• Physiological effects of POPs

  • Cardiovascular Disease

  • Diabetes

  • Neurologic Dysfunction - ADHD

  • Obesity

• Biomarkers – GGT, uric acid, possibly homocysteine

Triclosan

• Used as a disinfectant; historically present in antibacterial hand soap, detergents, and dish washing liquids (banned in the US in approximately 2014).

• Household products made with triclosan emit chloroform gas when combined with chlorinated tap water.

Principles of ecologically sustainable medicine

• Safe and harmless

• Clean and nontoxic

• Cost-effective

• Nonpolluting

• Adaptable and flexible

• Renewable

• Protective of the quality of the earth, the environment, and the earth’s natural resources

• Synergistic with human health and planetary well being

• Connected with the web of life

Precautionary thinking – premises (Ted Schettler, MD presentation at AHMA Annual Meeting 6/07)

• We have an obligation to prevent harm to the commonwealth

• Values and ethics are essential to decision making

• Science can provide guidance but not the whole answer

• Uncertainty and surprise are intrinsic to a complex world

• Government has a key role to play

• Some things are more important than money

• We hold the commonwealth in trust for future generations

• Prevention is wiser, fairer, and less costly than repairing damage

Practical measures to reduce waste and decrease the exposure to environmental toxins/EMF pollution

• Infants

  • Avoid canned meat baby food, due to extremely high levels of dioxins in these products.

  • Born Free Baby bottles – manufactured in Israel – free of bisphenol A (available on www.Amazon.com).

• Air (indoor)

  • NOTE that while the majority of PM2.5 originates outdoors, the majority of exposure happens indoors (and inside cars), as per Jacob Schor, ND (Townsend Letter. April 2022. 72-75).

  • HEPA filters - an intervention trial in Detroit, MI showed that HEPA filters can reduce indoor PM2.5 levels by approximately 50% (J Expo Sci Environ Epidemiol. 2019. 29. 484-490).

  • Be aware of sources of indoor air pollution – these include gas appliances, air fresheners, aerosol sprays, moth crystals, stored paints and solvents, gardening chemicals and pesticides, bottles of perfume and household cleaning products, incense.

• Food - eat organic; eat a nutrient-dense diet; ideally eat pasture fed meat and poultry, and wild fish

  • A study in children found that “the median urinary concentrations of the specific metabolites for malathion and chlorpyrifos decreased to the nondetectable levels immediately after the introduction of organic diets and remained nondetectable until the conventional diets were reintroduced” (Environ Health Perspect. 2006. 114. 260-263).

  • Data from NHANES 2007-2010 shows that the odds ratio of those who purchased organic food in the previous month was 0.80, meaning a diagnosis of diabetes was 20% less likely (Nutrients. 2018. 10. 1877).

  • At the very least, avoid the fruits and vegetables at the top of the list of those most ‘contaminated’ with pesticides – for an updated list, Google “Dirty Dozen” - the Environmental Working Group updates this list is periodically.

  • Optimum nutrition can modulate the toxicity of a wide variety of environmental toxins (Environmental Health Perspectives. 2012. 120. 771-774).

  • www.vitalchoice.com for wild salmon.

  • Pasture raised meat and poultry (free range does not necessarily mean that the animals feed on grass as opposed to corn meal)

    • www.americangrassfedbeef.com; www.texasgrassfedbeef.com; www.nimanranch.com; www.kosherbison.com

• Plants

  • 50 house plants have been found to remove a variety of toxins (i.e. formaldehyde, VOCs), based on data gathered by NASA, using plants in sealed test chambers (i.e. Biohome). Ten of the most efficient plants at removing toxins are Boston ferns, gerbena daisies, dwarf date palms, bamboo palms, rubber plants, English ivy, weeping figs, peace lilies, areca palms, and schefflera (Wolverton BC. How to Grow Fresh Air. 1996).

  • Spider plant removes carbon monoxide

  • Boston ferns, chrysanthemums, striped Dracaena, rubber plants, and dwarf date palms remove formaldehyde (found in new carpets, acrylic paints, particle board).

  • Peace lily removes benzene (found in dry-cleaned clothing and oil-based paints).

  • Draceana removes trichlorethylene (released by photocopiers and printers).

  • Areca palm removes toluene (found in nail polish, perfume, permanent markers).

• Water

  • Carry water in stainless steel or glass bottles; avoid bottled water in plastic bottles and avoid Nalgene hard plastic water bottles, as most contain bisphenol A. Two sources of stainless steel bottles are www.GreenFeet.com and www.isabellacatalog.com.

  • Use a water filter – scroll to bottom of Nutrition outline on this website for information on various types of water filters.

  • Test your water if not on a public system (public system reports are available to all consumers once a year) – to find a certified lab, contact the local health department or call the federal Safe Drinking Water Hotline at 800-426-4791.

  • Consider a portable water filter for travel – one such unit is the Trav-L-Pure unit available at www.purewaterplace.com.

  • Consider a shower head filter - the chlorine absorbed by the body during a 10 minute shower is approximately equivalent to the amount in 2 gallons of chlorinated water. Units are generally $50, with replacement filters ~$20. Replace filter every 6 months.

    • Befit shower filter or Rainshower filter at 1-800-497-9516 or www.cutcat.com

    • Shower-Cleen Triple Shower Filter at www.realgoods.com

    • Rainshow’r at 1-800-456-9887 or www.toolsforwellness.com

    • Turbo Shower at 1-800-634-1380 or www.needs.com

  • Consider a bath faucet filter - www.cutcat.com (Bath Ball for $45) or www.needs.com (Bath Ball for $45)

  • Consider a portable water bottle (for travel) with a charcoal filter (plastic, but no BPA) www.purewater2go.com

• Arsenic reduction strategies (Consumer Reports. 11/12. 22-27)

  • Minimize intake of brown rice, various rice foods and rice drinks (see chart pg 27).

  • Rinse raw rice prior to cooking, use a ratio of 6 cups of rice to 1 cup of water for cooking, and drain the excess water afterward – traditional method of cooking in Asia. Some loss of nutrients, but this method removes about 30% of rice’s inorganic arsenic content.

• Lead reduction strategies (Consumer Reports. 12/07. 15)

  • Evaluate lead risks in your home if constructed prior to 1978 – go to http://epa.gov/lead and click on Lead Professionals on the left side of the page, or go to www.centerforhealthyhousing.org for information on lead abatement.

  • Check recall lists at www.cpsc.gov.

  • Tips on preventing lead exposure through toys and consumer products available at www.ConsumerReports.org on the safety blog.

  • Adequate consumption of calcium and iron minimizes absorption of lead, and calcium may help to chelate and remove small amounts of lead already in the body.

• Mercury reduction strategies

  • Avoid medical waste incineration

  • Avoid mercury containing devices (thermometers, BP cuffs)

  • Avoid the use of mercury as a fixative in vaccines and other products

  • Sink traps in dental offices

• Air fresheners

  • Stay away from synthetic fragrances, which can be an allergy trigger, and may emit potentially dangerous phthalates and volatile organic compounds.

  • Greener picks include Ecodiscoveries AirZme, which uses natural enzymes, and Earth Friendly Products Eco Breeze Fabric Refreshener, which uses essential oils, or a bowl filled with dried sage or thyme.

• Automobiles - replace the air filter annually, and consider a HEPA air filter for the car

• Bathroom

  • Minimize mold on tile and grout by opening a door or window to allow for circulation of air, or use a ceiling fan

  • Consider a small dehumidifier, such as a ClosetMate Dehumidifier.

  • Use tea tree oil (2 teaspoons with 2 cups of water) in a spray bottle to remove mold

• Basement

  • Radon – use a test kit (available on line and at hardware stores), and if level is > 4 picocuries per liter of air, EPA recommends installation of a radon mitigation system (typical cost is $1000 - $2000).

  • Minimize water entry from the outdoors and consider a dehumidifier.

• Batteries

  • Alkaline batteries (each contain a miniscule amount of mercury) – bring to the monthly meeting of Niagara Frontier chapter of ADK (2nd Tuesday of the month, Amherst CommunityChurch, 77 Washington Highway, Amherst, NY 14226) and drop in the box set up by the Conservation Committee.

  • Rechargeable batteries (contain heavy metals) – drop off at Best Buy stores.

• Bedroom

  • Linens – to make linens wrinkle resistant, they are often treated with formaldehyde, and synthetic bed linens (permanent press polyester) don’t breathe like natural fibers, so strive for sheets made of organic cotton.

  • Mattresses – most mattresses contain polyurethane foam and polyester; best to purchase a natural mattress, or a natural mattress “topper” made of wool.

    • For organic mattresses, see Resources section below. Ikea mattresses do NOT contain PBDEs.

    • For PDBE (a toxic flame retardant)-free mattresses, go to www.ewg.org/pdbefree.

• Bisphenols

  • Baby bottles

    • Born Free Baby bottles, www.newbornfree.com – manufactured in Israel – free of bisphenol A (available on www.Amazon.com)

    • Gerber’s Clearview bottles - $3 for a three-pack at Target

  • Reduce use of canned foods, as the cans may be line with a material containing BPA.

    • Canned food in BPA-free cans – Eden Foods – www.edenfoods.com

    • NOTE that minimizing packaged foods or canned foods (in cans with BPA) can reduce mean BPA levels by 665 and DEHP metabolite levels by 53-56% (Environ Health Perspectives. 2011. 119. 914-920).

• Bug repellents – see Insect repellents

• Cars – if an attached garage, don’t run the car in the garage, make certain door to house from the garage is airtight (weather-stripping or fire-rated door), and leave outer garage door open for a minute or two after pulling car into garage, to allow fumes to escape.

• Candles –see ‘Home Products’ just below

• Carpet cleaning – see ‘Cleaning Agents’ below

• Cars - see ‘automobiles’ above

• Cell phones

  • Limit cell phone use as much as possible.

  • Keep the cell phone turned off as much as possible.

  • Do not carry the cell phone on your body, if possible.

  • If the cell phone is clipped to your belt, have the key pad face your body, as the antenna on the back of the phone is a bit further from your body. On flip phones, the antenna is on the back of the earpiece part of the phone.

  • Use speaker phone feature whenever possible, and keep the phone itself is a few feet away from the body. If you hold the phone to your ears, switch ears regularly.

  • Consider an air tube ear piece, which conducts less EMF than a wired ear piece

    • One such product, the RF3 Air Tube headset, is available at 1-800-578-5939 or www.blockemf.com (click on ‘Cell Phone Protection’ in the upper left and then scroll down to nearly the bottom of the page labeled http://www.blockemf.com/catalog/index.php?cPath=746). The ear bud style is available for $20 and the ear hook style is available for $33.

    • A second product, the Blue Tube headset, is available at http://shop.mercola.com/ShoppingCart.aspx for $35.

  • Consider the use of an EMF protection device on the phone – one such device is a ‘Bio Chips Pro Disc,’ available at 866-999-2747 or www.MyProDisc.com.

  • Choose a new cell phone that emits a lesser amount of radiation - ranking of cell phones by how much radiation each emits www.ewg.org/cellphone-radiation

  • Recycle old cell phones - reduces demand for coltan, a metallic ore in the phones. Demand for this ore is triggering illegal mining in national parks in the Congo, destroying elephant and gorilla habitats. See ‘Recycling’ below

• Cleaning agents – open a window when cleaning

  • NOTE products with the Design for the Environment (DfE) label from the EPA have been screened by a third party and contain relatively safe ingredients

  • NOTE Green Works is the Chlorox Company biodegradable line of cleaning products

  • NOTE certified biodegradable is a term that is independently verified (Consumer Reports. 1/08. 6).

  • NOTE fragrances are NOT required to be listed as product ingredients (Consumer Reports June 2012), and one fragrance can contain 50-200 compounds, including dozens of volatile organic compounds.

  • NOTE companies with products for which there are testimonials of effectiveness include Biokleen and Seventh Generation (available in health food stores).

  • NOTE toilet and glass cleaners often contain ammonia, cresol, ethanol, and phenol, which can irritate the lungs and skin.

  • Label information (Consumer Reports. May 2015. Page 7).

    • In 2015, the green leafy “Safer Choice” label signifies EPA recognition of less toxic ingredients, and meets the approval of Consumer Reports.

    • Be wary of ‘antibacterial’ on the label, as these products often contain dimethyl benzyl ammonium chloride or triclosan, both chemicals to be avoided.

    • Bleach in a 1:32 dilution is OK to use on occasion.

  • All purpose cleaner

    • Avoid products with glycol ethers (labeled as Butyl Cellosolve, 2-butoxyethan, or ethylene glycol monobutyl ether), as this solvent strips hands of their natural oils, and can be absorbed through the skin.

    • Avoid products with diethanolamine (DEA) and triethanolamine (TEA), as these sudsing agents react to nitrate and may form carcinogens that can penetrate the skin.

    • Greener picks include Chlorox Green Works All-Purpose Cleaner, Chlorox Healthcare Bleach Germicidal Wipes, Earth Friendly Products Parsley Plus All-Surface Cleaner and Vermont Soap Organics Liquid Sunshine

  • Bleach - hydrogen peroxide (or borax) are alternatives to bleach (bleach contains chlorine).

  • Carpet cleaning – use an unscented product without petroleum distillate, alcohol or ammonia.

  • Dishwashing liquids

    • Avoid petroleum-based components, as this increases dependence on imported oil.

    • Avoid synthetic fragrances

    • Greener picks include Mountain Green Dishwashing Liquid, Mrs. Meyer’s Dish Soap, and Earth Friendly Products Dishmate.

    • Home-prepared alternative: 4 tablespoons of liquid Castile soap, 2 ½ cups of water, 6 drops of lavender essential oil, and 5 drops of bergamot essential oil, and shake.

  • Dishwashing detergents

    • Avoid phosphate, as this is discharged into lakes and rivers, and fosters overgrowth of algae.

    • Greener picks include Ecover Automatic Dishwasher Powder, Seventh Generations’s Free & Clear Automatic Dishwashing Detergent, and Earth Friendly Products Wave.

  • Floor cleaner

    • Avoid products with 2-Methoxyethoxy ethanol, as this may cause developmental and reproductive abnormalities

    • Avoid products with Monoethanolamine, which can cause asthma

    • Greener pick is BabyGanics Floor Cleaner Concentrate

  • Furniture and wood cleaners

    • Avoid aerosol sprays

    • Greener pick is pump sprays such as Earth Friendly Products’ Furniture Polish

  • Glass cleaner

    • Avoid products with ammonia, which is highly irritating to the lungs. NEVER mix ammonia with bleach, as this creates toxic fumes.

    • Avoid solvents

    • Avoid butyl cellulose

    • Greener picks include Ecodiscoveries Glass and Aubrey Organics Liquid Sparkle Spray Cleaner, Staples’ Sustainable Earth Glass Cleaner, and vinegar

    • Homemade glass cleaner (Consumer Reports June 2012) – mix 1 ½ cups of vinegar, ½ cup of water, 8 drops of a citrus essential oil such as lemon in a spray bottle and shake.

  • Laundry detergents and fabric softeners

    • Beware that many detergents include petroleum distillates, bleaches, synthetic whiteners, and artificial fragrances.

    • Avoid benzenes, as dryer sheets with benzenes release toxic gases when heated

    • Avoid Borax and enzymes, which can destroy the fibers of clothes

    • Avoid Bounce, as it contains 17 neurotoxic compounds.

    • Avoid monoethanolamine, which can cause asthma

    • Avoid Tallow, which makes towels less absorbent, and can clog the lint filter

    • Unscented powdered laundry detergent is best - choices include Mountain Green Laundry Detergent, Safonique Detergent

    • Seventh Generation Fabric Softener is environmentally friendly.

    • White vinegar is a fabric softener – combine in a heavy plastic container 6 cups of vinegar, 1 cup of water, 1 cup of baking soda, and 15 drops of lemon essential oil, and use 1 cup for each rinse cycle (use ½ cup when washing bright colors)

  • Lawn and garden equipment – ideally store gas-powered equipment in a shed, as gasoline even in the tank of the equipment releases fumes.

  • Mirrors – see “Glass Cleaner”

  • Rug odor – sprinkle baking soda, wait 15 minutes, then vacuum

  • Showers – see ‘Tub and Tile’ just below

  • Sink – see ‘Toilet’ just below

  • Stain removers

    • Beware many contain perc, the solvent used in dry cleaning, which emits carcinogenic fumes.

    • Blood – remove by rinsing with cold water, then making a paste of equal parts water and baking soda, and use a brush to remove the dried paste.

    • Chocolate – make a paste from 1 tablespoon of borax, 1 tablespoon of baking soda, and ¼ cup of cold water, apply to stain, scrub lightly with a brush, let sit for at least 10 minutes, rinse with cold water, and air dry.

    • Ink – make a paste of equal parts of cream of tartar and lemon juice, apply to stain and allow to set for 30 minutes, then wash with cold water.

  • Toilets

    • Avoid cleaners with hydrochloric acid

    • Greener pick is Seventh Generation Natural Toilet Bowl Cleaner

    • Use baking soda or vinegar and a toilet brush

    • Combine 2 cups water, ¼ cup liquid Castile soap, 1 tablespoon tea tree essential oil, and 10 drops of Eucalyptus or peppermint essential oil in a spray bottle and shake well. Spray the surface then wipe with a brush or sponge.

  • Tub and Tile

    • Avoid sodium hydroxide, sodium hypochlorite, and phosphoric acid, which can all burn the eyes and skin, and irritate the lungs

    • Avoid organochlorine, shown to cause cancer in animals.

    • Avoid ammonium quaternary compounds, which may cause asthma

    • Greener picks include Naturally Clean Tub and Tile, BioShield Toilet Bowel Cleaner, Bon Ami, and baking soda.

    • Homemade cleaner – in 16 ounce spray bottle, mix 2 tablespoons borax (sold in supermarkets),4 tablespoons apple cider vinegar, ½ teaspoon eucalyptus essential oil, and ½ teaspoon lavender essential oil, shake, fill with water, and shake again. Spray this mixture onto surfaces, scrub tile and grout with a soft bristle brush, and then rinse with water (Laurel Vukovic. Natural Health Magazine. May/June 201. Pg 44).

• Cockroaches – see ‘Pest Control’ section just below

• Computers

  • Most items contain heavy metals, so best not to discard in the trash.

  • See if the retailer or manufacturer offers free recycling. Dell since 2004 offers free recycling, with customers either arranging free shipping online, or dropping off Dell computers and accessories at a Staples store.

  • BAN, an e-waste watchdog group, lists responsible recycling organizations at www.ban.org.

• Cookware

  • Beware aluminum is a toxic metal which is commonly used in cookware.

  • Avoid nonstick cookware (other than ceramic) to limit exposure to PFAS.

  • Safe alternatives include glass, cast iron, enamel-coated iron, 100% stainless steel, porcelain, lead-free terra cotta, and aluminum pans lined with stainless steel or anodized.

• Deodorants – safer alternatives (see above in this outline for potentially problematic ingredients). When switching to a safer deodorant, realize that it may take the body a week to readjust, with increased body odor for the transition period (Natural Solutions. 8/08. Pgs 36-39)

  • Mineral salts (ammonium or potassium alum) work by constricting the protein in the sweat glands, so that malodorous bacteria have less to feed on.

  • Clay minerals (kaolin, bentonite) and natural powders (cornstarch, arrowroot) help absorb moisture.

  • Astringents (witch hazel, sage, alcohol) work by evaporating the moisture on the skin and constricting the pores.

• Dioxin elimination strategies

  • Avoid medical waste incineration

  • Purchase PVC alternatives when available

• Dry cleaning - alternatives to perc

  • Carbon dioxide - better results than even conventional dry cleaning. www.hangersdrycleaners.com for locations.

  • Silicone-based - marketed as Green-Earth cleaning, and results comparable to conventional dry cleaning. www.greenearthcleaning.com for locations (Colvin Cleaners in Buffalo, NY).

  • Wet-cleaning - recommended by GreenPeace, but results poor, so consider only for clothing you would consider hand-washing (Eco Friendly Custom Cleaners in Buffalo, NY).

• Electronics

  • Most items contain heavy metals, so best not to discard in the trash.

  • See if the retailer or manufacturer offers free recycling.

  • BAN, an e-waste watchdog group, lists responsible recycling organizations at www.ban.org.

• Food packaging (take out, leftovers) - transfer to glass containers, and avoid reheating food still in takeout containers

• Fireplaces

  • Wood fires release benzopyrene, a carcinogen.

  • Open window a crack to allow pollutants to escape the room

  • Annual inspection for creosote build-up, as creosote can lead to a fire in the chimney

• Home products/furniture/flooring (www.coejl.org and http://householdproducts.nlm.nih.gov) - use formaldehyde-free products with low or no VOC’s (volatile organic compounds).

  • Appliances – look for the Energy Star label.

  • Athletic shoes – recycle. Nike Reuse-A-Shoe program www.nikereuseashoe.com

  • Candles

    • Beware that despite a CPSC 2003 ban on lead wicks, some imported candles have tested positive for lead emissions.

    • Paraffin wax (a petroleum product) produces benzene when burned.

    • All candles produce soot when burned, and this can cause respiratory symptoms. Scented candles create more soot when burned.

    • Soy or beeswax candles with cotton wicks have the least detrimental impact upon human health.

  • Carpeting

    • Synthetic carpeting as well as the padding and adhesives used to lay it down are sources of VOC’s, such as benzene and toluene (off-gassing).

    • Carpets also emit PDBE’s - vacuum frequently to reduce the PDBE content of the dust.

    • Purchase carpeting made from jute, wool, or organic cotton

  • Cleaning (sinks, tubs, and toilets) – consider using baking soda.

  • Clock radios - move away from the bed at least 12 inches, because the EMFs interfere with the release of melatonin in the brain.

  • Computer monitors – emit electromagnetic (EM) radiation; LCD screens of laptops emit less EM radiation. Radiation filters further reduce EM radiation exposure.

  • Furniture

    • Beware pressed wood and particleboard products may emit formaldehyde fumes, based on the glue used to bond pressed-wood products - choose natural hardwoods or bamboo as alternatives.

    • Beware polyurethane foam and polyvinyl chloride in furniture emit harmful fumes

    • Ikea furniture does NOT contain PBDEs.

    • Avoid scotch guard treatments, as these are sources of PFCs - buy directly from the manufacturer

    • Use vegetable oil and lemon juice as furniture polish.

  • Household Cleaners – see ‘Cleaning Agents’ just above

  • Light bulbs – see top of outline for information.

  • Linens – see bedroom

  • Mattresses – see bedroom

  • Paint

    • Choose brands with zero or low VOC brands, as studies have linked exposure to VOC’s with headaches, nausea, and kidney damage.

    • Choose brands without glycol ethers, as exposure to petroleum-based solvents is associated with an increased risk of poor semen quality (and potentially male infertility).

    • Indoors, keep windows open and fans running while painting and for a few days afterwards.

    • Water-based paints tend to emit fewer odors than oil-based paints.

    • AFM Safecoat Zero VOC paint is made without ethylene glycol.

    • Test for lead using an EPA or state certified professional using an XF machine, or have paint chip analysis by and EPA-certified lab; follow EPA guidelines for removing lead paint (consider leaving undisturbed if in good condition).

  • Paper – use recycled, unbleached paper

  • Permanent press (sheets, clothing, and curtains) – beware may emit formaldehyde fumes.

  • Pots and pans (Consumer Reports. May/June 2023. 52-59)

    • Beware of limitations of labels

      • “PFOA free” does NOT mean that the product might not contain any of the thousands of other PFAS (see section on PFAS above on this web page).

      • Even products made without PFOA might contain some PFOA created as a byproduct of other PFAS

      • Of the thousands of PFAS, technology exists in 2023 to measure/quantitate only approximately 100 of these compounds

      • “Free” may not mean zero, but rather below a specific level specified by a regulatory agency

    • Teflon

      • This is the name for a nonstick coating called PTFE, which is PFAS in polymer form

      • Pans in good condition likely cause minimal risk to human health, as PTFE is polymer which is too large to be absorbed; HOWEVER pans with scratched coatings or pans cleaned with steel wool likely do pose a risk to human health.

      • Preheating an empty Teflon pan might trigger release of toxic fumes

    • Pots and pans with maximum safety (in 2023)

      • Stainless steel

      • Ceramic nonstick

      • Coated cast-iron

      • Uncoated cast-iron

      • Carbon steel

      • Porcelain enamel

  • Shower curtains - these emit PVC’s; choose a fabric shower curtain or 100% PVC free shower curtain.

  • Window coverings - natural materials such as wood, bamboo, or organic cotton are alternatives to plastic.

  • Wood – choose formaldehyde-free Forest Stewardship Council (FSC) certified wood.

  • Vacuum - use one with a HEPA filter

• Ink cartridges – drop off used ones at Best Buy stores.

• Insect repellents

  • Most commercial insect repellents contain DEET, a toxic pesticide

  • Andrew Weil, MD recommends products containing gerianol, derived from the geranium plant – BugBand (www.bugband.net) is one brand. It is sold at Johnson’s Country Store, Lockport, NY 14094, 716-434-9411

  • CDC in 2005 approved picardin and oil of eucalyptus as efficacious alternatives to DEET

    • Cutter Advanced with 7% picardin is as effective as 10% DEET (Consumer Reports. 7/05. Pg. 6).

    • Repel (oil of lemon eucalyptus) is also as effective (Consumer Reports. 8/05. Pg. 6).

  • Other natural bug repellents include Burt’s Bees Herbal Insect Repellant, Buzz Away, and oil of citronella.

• Kitchen

  • Dish soap and dish washing detergent – see “Cleaning Agents”

  • Sponges – microwave for 60 seconds, or toss in dishwasher each time you run a load

• Lawn – avoid or minimize the use of chemical fertilizers 

• Light bulbs – compact fluorescent bulbs (contained about 5 mg mercury per bulb in 2008, generally less than 1 mg per bulb in 2011) - drop off used bulbs for recycling at Home Depot, Ikea, and some Ace and True Value stores.

• Linens – see ‘bedroom’

• Mattresses – see ‘bedroom’

• Medical office – use cloth gowns and towels

• Medication

  • Federal guidelines for drug disposal suggest mixing unused medication with coffee grounds or cat litter, placing in a sealed container, and throwing out with the trash (except for some controlled substances, which the government still recommends flushing down the toilet, as of 2008).

  • Some pharmacies have take-back programs for unused medications.

• Menstrual hygiene products - the menstrual cup (Women's health.  Menstrual Cup.  JAMA.  2023. 329. 1114-1115)

  • The menstrual cup is a reusable, flexible, self-retaining intravaginal menstrual fluid collection device.

  • Menstrual cups have been available for purchase since the 1930s, and in 2019, there were 199 brands available for purchase globally,

  • The cup can collect between 10 and 38 mL of blood and can be inserted for up to 12 hours.

• Mold

  • Information in Dr. Doris Rapp’s book Our Toxic World (2004). Also see ‘Cleaning Agents - Tub and Tile’ section of this outline above

    • The product FEN-X TM PRO-TEC, which is a purely organic enzyme-based substance, is thought to eliminate the mold in the air and inside the walls, possibly avoiding major mold remediation (EnviroGen Technologies, Stephen.gorton@verizon.net, 214-244-4192).

    • Homeopathic products Mucosa compositum (800-621-7644) and Opsin II may be helpful.

    • Wash moldy items with bleach, one cup of bleach per gallon of water (hydrogen peroxide is an odorless alternative, but less effective).

    • A trichothecene urine or patch test is available (Croft W et al. Clinical confirmation of trichothecene mycotoxicosis in urine. Journal of Environmental Biology. 2002. 23. 301-320), and might help to confirm the presence of mold-related illness.

    • Mold websites and mold consultants are listed in Appendix C of Dr. Doris Rapp’s book, Our Toxic World (2004).

  • Information in Consumer Reports on Health June 2021

    • Keep indoor humidity at 30% - 50% as per the EPA

    • In bathrooms use either mildew-resistant paint or paint in a satin or high-gloss finish, as these create a smooth surface

    • Washing machines - use high efficiency detergent to avoid residue, avoid using fabric softener, transfer laundry to dryer as soon as cycle is finished, wipe inside of door and gasket in between loads, leave door open in between loads so that fresh air can circulate

• Nanotechnology - the Project on Emerging Nanotechnologies maintains a database of hundreds of nano-based products ranging from socks to car wax – www.nanotechproject.org/inventories/consumer.

• Office supplies

  • Liquid correction fluids and permanent pens and markers may contain acetone, cresol, trichloroethylene, toluene, and naphthalene, which have been linked to a range of health problems.

  • Confection tape (manufactured by 3M and Papermate) is an alternative to correction fluid.

  • Pens and markers – avoid the word “permanent”

  • Printers and photocopiers – emit ozone, and thus keep in a well-ventilated space, step away while operating, consider cracking a window. Add houseplants to filter the air.

• Paint – see “Home Products”

• Personal care products (also see ‘skin moisturizers’ just below)

  • Avoid products with estrogenic substances (products with estrogenic substances are widely used in African American communities)

  • Avoid products with parabens, as this common preservative may be weakly estrogenic. Sodium benzoate, a fruit derived preservative, is safer (Self Healing. 1/08. Pg 8).

  • Avoid products with ‘synthetic fragrance’ as these may include phthalates; ingredients of ‘synthetic fragrance’ are not required to be listed on the label.

  • BEWARE that many products labeled as ‘natural’ may have toxins and endocrine disruptors as ingredients.

  • Hair spray – beware that most contain formaldehyde and polyvinylpyrrolidone plastic, known carcinogens.

  • Nail polish – beware that most contain dibutyl phthalate, formaldehyde, and toluene, toxins known to irritate the skin and respiratory tract, and which may cause cancer, liver damage, and birth defects.

  • Nail polish remover – beware that most contain acetone and ethyl acetate, which can irritate the eyes, nose, and throat.

  • Resources include data gathered by the Environmental Working Group, at http://www.cosmeticsdatabase.com/index.php?nothanks=1 and also www.safecosmetics.org. Whole Foods Markets has investigated and determined that over 250 toxins are unacceptable – Natural Solutions magazine has incorporated this information onto its website, at www.naturalsolutions.com/go/beauty and in an article in the October, 2008 issue (pp 69-75).

• Pest control (Natural Health Magazine. May/June 2001. Pg 77).

  • Ants – seal entrance cracks with caulk, keep food in closed containers, empty garbage daily, spray ant nests with hot or soapy water, bait with a mixture of homemade mixture of boric acid and mint jelly (3 cups water with 1 cup of sugar and 4 teaspoons boric acid in a screw-lid jar, and poke holes in the lid).

  • Cockroaches – seal entrance cracks with caulk, use a dehumidifier, clean up clutter. Spray boric acid along baseboards and behind, between walls via electrical outlets and light switches (remove plates and spray).

  • Fleas – bathe pet using limonene (an insecticidal soap), brush with a flea comb regularly, add chopped garlic (1 clove daily for a large dog) to pet food, wash pet bedding and vacuum carpets weekly.

  • Houseflies – keep garbage containers tightly covered, use fly swatters. Make bait by mixing 1 pound of sugar, 1 pound of baking powder, 2 ounces of baking yeast, 6 ounces of fish meal, ¼ cup of honey, and 2 tablespoons of water – freeze in ice trays and then dissolve one cube in one quart of water and set container in infested area.

  • Mice – seal potential entrance ways. Set snap traps, sprinkling flour near the traps, and alternating bait (candy and fruit). Consider a sonic repellant which emits high frequency sound waves to scare away rodents.

• PFAS - the chemicals in this class are abundant in water and food packaging

  • Avoid food packaging/take-out whenever possible

  • Avoid eating microwave popcorn

  • For storage of food in the kitchen, and for cookware, replace all plastic containers and replace Teflon pots and pans with glass, stainless steel, or ceramics.

  • Carbon block filters are effective at removing PFAS from the water

• Plastics

  • Plastic containers for food storage - general principles (Editorial. Pizzorno, Joseph. Integr Med. 2024. 23[2]. 6-10).

    • Avoid using plastic food containers to the extent feasible

    • If using plastic food containers, use only those labeled as food-grade

  • Safety of food containers as a function of the recycling code on the container is as follows (Dr. Pizzorno in this editorial states In the conclusion "This is one of the most frustrating editorials I have written.  The huge inconsistency between the many studies… not able to reach a (high) level of certainty").

    • Safest are #2 (HDPE - milk and water bottles), #4 (LDPE) solid containers, and #5 (PP - yogurt containers and syrup bottles).

    • Intermediate safety are #1 (PET or PETE - soft drink and water bottles) and #6 (PS - foam containers and cups, some clear disposable takeout containers, some plastic cups).

    • Highest risk are #3 (PVC - plastic wraps for grocery store food), #4 (LDPE) food wrap, #6 (PS) when heated, and #7 (other).

  • Store food, especially fatty food in glass or ceramics instead of plastic

  • Never heat food in plastic or while using a plastic wrap

  • Never use plastic in a microwave, even if it is “microwave safe”

  • Avoid washing plastic items in the dishwasher, as this may cause phthalates to leach out onto other items.

  • Throw out scratched or hazy looking plastic containers.

  • Make coffee or tea some way other than running hot water through a plastic appliance – alternatives include glass and stainless steel

  • Cosmetics – go to www.thinkbeforeyoupink.org/Pages/PhthalateFree.html for a list of phthalate-free cosmetics.

  • Nail polish – check the labels, as phthalates are used in some nail polishes to reduce cracking

  • Personal care products - avoid products with ‘synthetic fragrance’ as these may include phthalates; ingredients of ‘synthetic fragrance’ are not required to be listed on the label.

  • Toys- look for phthalate free toys (those approved by the European Union) – go to www.healthytoys.org for PVC free toys

• Skin moisturizers – as per www.Mercola.com, avoid products with the following ingredients

  • Acrylamide – linked to mammary tumors in lab research.

  • Dioxane - carcinogenic

  • Mineral Oil, Paraffin, and Petrolatum – petroleum products that coat the skin like plastic, clogging pores and creating a build-up of toxins, which in turn accumulate and can lead to dermatologic issues.

  • Parabens – preservatives which have hormone-disrupting qualities

  • Phenol carbolic acid – can cause circulatory collapse, paralysis, convulsions, coma

  • Propylene glycol – may cause dermatitis, kidney or liver abnormalities, and may inhibit skin cell growth or cause skin irritation.

  • Sodium laurel or lauryl sulfate (SLS), also known as sodium laureth sulfate (SLES) –SLS breaks down the skin’s moisture barrier, easily penetrates the skin, and allows other chemicals to easily penetrate. Combined with other chemicals, SLS becomes a “nitrosamine”, a potent class of carcinogen.

  • Toluene – Butylated hydroxytoluene (BHT) contains toluene. Chronic exposure linked to anemia, lowered blood cell count, liver or kidney damage, and may affect a developing fetus.

• Soda - BEWARE that soda with added vitamin C and with sodium benzoate as a preservative may have benzene levels above the EPA limit of 5 ppb for drinking water. In a recent FDA and EPA study, almost 5% of 200 beverage samples had benzene levels above 5 ppb (accessed 1/26/08 at www.mercola.com).

• Sunscreen – products which do NOT contain nanoparticles (as per manufacturer) and do not contain organic chemicals shown in some studies to disrupt hormonal function.

  • Alba Botanicals Fragrance Free Mineral Sunscreen - chemical free and nanoparticle free as per the manufacturer, contains titanium dioxide, but does NOT leave a thick white film as per a 2008 Natural Solutions magazine report. www.albabotanica.com. INEXPENSIVE. $9.95 for 4 ounces.

  • Anthelios SX – ecamsule

  • Aubrey Organics – advocated by Mercola.com advocates sunscreens as safer than conventional sunscreen.

  • E rbaviva Sunscreen - chemical free and nanoparticle free as per the manufacturer, contains titanium dioxide, but does NOT leave a thick white film as per a 2008 Natural Solutionsmagazine report. Fresh herbal scent. www.herbaviva.com. $38 for 4 ounces.

  • Lavera Family Sun Spray - chemical free and nanoparticle free as per the manufacturer, contains titanium dioxide, but does NOT leave a thick white film as per a 2008 Natural Solutionsmagazine report (EDITORS PICK). www.lavera.com $26.50 for 6.6 ounces.

  • Lotus Moon Sage Sun Protective Creme - chemical free and nanoparticle free as per the manufacturer, contains titanium dioxide and zinc oxide, but does NOT leave a thick white film as per a 2008 Natural Solutions magazine report. EXPENSIVE. www.lotusmoon.biz. $32 for 2 ounces!

  • Neutrogena –CR highest overall score 7/07, pg 6

  • No-Ad – CR Best buy 7/07, pg 6

  • Total Sun Protection Cream – Life Extension Foundation 800-544-4440. Contains beta glucan, green tea extract, grape seed extract, milk thistle extract, licorice extract, rosemary extract, and curcumin extract. $28 for 4 ounces.

  • UV Natural Sunscreens – chemical free and nanoparticle free as per the manufacturer, contains zinc oxide, a bit oily, but does NOT leave a thick white film as per a 2008 Natural Solutions magazine report. www.uvnaturalusa.com $33.50 for 5.29 ounces.

• Vacuum - use one with a HEPA filter

• Water - safety information

  • Information on safety of drinking water by community available at www.epa.gov/safewater/dwinfo.htm and information on certified testing labs available at www.epa.gov/safewater/labs or by calling 800-426-4791.

  • Allowing tap water to run for 30 seconds before drinking it eliminates much of the lead.

  • Chlorination of public water is essential at the source to kill bacteria in the water, but if there is residual contamination of water with byproducts of sewage, the chlorine may convert these into carcinogenic agents (chlorine combines with naturally occurring organic matter in water to form trihalomethanes [THMs], which have been linked to an increased risk of bladder and colorectal cancers). Chlorine consumption is not ideal for human health - boiling tap water or allowing it to sit in an open-mouth pitcher for 1-2 days before use eliminates much of the chlorine, because chlorine is volatile and evaporates.

  • Fluoridation of water is controversial regarding whether there is a beneficial effect with regard to decrease in dental caries – fluoride consumption is not ideal for human health.

  • The people at greatest risk from contaminants in tap water are the 28 million Americans served by small public water systems which serve fewer than 3300 customers each, because these are inspected less frequently than larger systems. Large systems are usually quite safe. Reports of levels of chemicals present in public water systems are readily available to the public.

  • Cloudy tap water may signal a problem with parasitic contamination, because cloudy water indicates that the filters at the intake are letting through particles, and thus may be letting through parasites too. Parasites are not effectively killed by chlorination.

• Water - bottles (and for detailed information on brands of bottled water and categories of bottled water, navigate to www.drlevyhealthinfo.com/nutrition and scroll about 3/4 down this page to the section on Water).

  • Bottled water is ideally consumed from stainless steel bottles or glass bottles - stainless steel bottles can be purchased at www.GreenFeet.com or www.isabellacatalog.com

  • Avoid use of Nalgene (hard plastic) bottles, and if you do use them, don’t heat them, as exposure of these bottles to high heat can damage the plastic and lead to chemicals from the bottle leaching into the water

  • Avoid soft plastic water bottles as they may leach chemicals into the water inside them. Do not freeze soft plastic water bottles with water in them as this increases the release of dioxins from the plastic, and note that conversely exposure of these bottles to high heat can damage the plastic and lead to chemicals from the bottle leaching into the water.

  • Note that from a regulatory perspective, bottled water is regulated the same as tap water - a label though of ‘purified bottled water’ typically means that the water has undergone filtration prior to bottling

  • Environmental perspective - strive to avoid using plastic water bottles, as production generates greenhouse gases, and the empty bottles contribute significantly to “environmental pollution” as they take up space in landfills, and leach chemical over subsequent centuries

• Water - testing for contaminants (Consumer Reports. May 2021. Page 40; January 2024. Page 28).

  • If your water comes from a public utility, obtain an annual water report (these are usually issued in July of each year, and mailed to the address of the person paying the water bill).

    • Note 90% of Americans get their water from one of the 148,000 public systems overseen by the EPA

    • Utilities serving > 100,000 customers must make the reports available on their web site

    • Make sense of the report - the summary at the top shows whether any contaminants were found above the government cutoffs. For assistance interpreting the report, call 800-426-4791.

    • See whether the report includes PFAS (not mandatory to report in most states in 2023, but requirements are changing)

    • Compare EPA cutoffs with EWG cutoffs, which are often lower (see section above in this outline on ‘Water Pollution’

    • Consider additional testing

      • Lead level on report shows average lead level taken from a sample of houses, but if your house is served by a lead line outside, or if you still have lead pipes in your house (built prior to 1986), the level in your house can be much higher.

      • PFAS if your utility does not report this - note PFOA and PFAS are most commonly tested, but there are 12,000 known substances in this class, and testing does not exist yet in 2023 for most of these compounds. Testing may cost $300-$400 in 2023,

  • Test your water annually (EPA recommendation) if not on a public system (or invest in a reverse osmosis system - for more information on reverse osmosis systems, see section on WATER 3/4 down the web page on this site entitled NUTRITION AND WATER)

    • Annual testing should include testing for bacteria, nitrates, radon and possible lead and PFAS

    • To find a certified lab, contact the local health department, or go to www.epa.gov/dwlabcert or click here.

    • Note some health departments offer free or low cost testing (the contaminants tested for may be limited)

    • Beware that many do-it-yourself kits sold at hardware stores, which allow you to test at home, as opposed to sending a sample of water to an outside lab, are of questionable validity.

    • Consider using a CR-validated mail-in kit (2023)

    • SimpleLab Tapscore (mytapscore.com) - $160 to test for contaminants in municipal water, $195 to test for contaminants in well water, and an extra $299 for PFAS testing

    • National Testing Laboratories (WaterCheck,com) - $195 to test for contaminants in municipal water, $205 to test for contaminants in well water, and an extra $499 for PFAS testing.

    • Cyclopure (cyclopure.com) - tests only for PFAS ($79)

• Water - filters - for information on various types of water filters, navigate to www.drlevyhealthinfo.com/nutrition and scroll about 3/4 down this page to the section on Water.

• Washing machines - see above “mold”

Practical measures to reduce the body burden of environmental toxins

• Consume adequate calcium (may assist with elimination of excess aluminum and lead), selenium (may assist with elimination of excess mercury), and zinc (may assist with elimination of excess cadmium).

• Detoxification regimen at least once a year – this is an element of all primitive “health care systems”

• Sauna (after obtaining medical clearance)

• The advantage of an infrared sauna is that lower temperatures can be used; this is often tolerated better by individuals with chronic disease

• One source of infrared saunas is High Tech Health, 1-800-794-5355.

Recycling Information (Consumer Reports. March 2011. 18-19)

• Athletic shoes (information updated January 3, 2020)

Nike Recycling Center
c/o Reuse-A-Shoe
199 Pearson Parkway
Lebanon, IN 46052

• Batteries

  • Alkaline batteries - not recyclable

  • Rechargeable batteries - Home Depot, Lowes, Staples, more information at https://www.call2recycle.org/

• www.earth911.com for drop-offs in your area

• Books – donate books to a local church, day care center, homeless shelter, library, nonprofit agency, school, or senior center

• Bicycles – www.recycleabicycle.org or www.pedalrevolution.org or www.ibike.org/environment

• Building supplies - Habitat for Humanity ReStores. www.earth911.com

• Cars – Goodwill, Habitat for Humanity, Donor’s Guide to Car Donations at www.irs.gov/pub/irs-tege/pub4303.pdf

• Cell phones

• Many zoos, including the Buffalo zoo (2006) participate in an ECO-CELL cell phone recycling program. Receptacle is located inside Buffalo Zoo’s main gate.

• Ace hardware, Best Buy stores, Home Depot, Lowe’s, Office Depot, Staples

• Clothing – Goodwill, Salvation Army, thrift stores

• Compact fluorescent bulbs - Home Depot, Ikea, Lowe’s, and some Ace and True Value stores allow consumers to drop off used bulbs

• Electronics (computers, televisions) – contact city or town Highway Dept for info on electronic waste drop-off sites.

• Furniture – Goodwill, Salvation Army, www.freecycle.org or sell on Craigslist or eBay

• Linens – animal shelter, Goodwill, Salvation Army

• Mattresses – shelters, www.earth911.com www.shepherdsdream.com

• Motor oil – service stations, Walmart lube centers,

• Paint – dispose oil based paints at your local household hazardous waste collection facility

  • Erie County Household Hazardous Waste Hotline 716-858-6800

  • www.earth911 for sites near you

• Stuffed animals – animal shelters

• Television recycling - old televisions contain toxic materials; ask the retailer from whom you purchase the new television whether they accept old televisions for recycling, or search for recycling options at www.earth911.com.

• Tennis balls - RecycleBalls is a Vermont-based organization which partners with gyms, athletic clubs, and players to repurpose the rubber in tennis balls for turf - this organization accepts only quantities of several hundred used tennis balls (National Geographic. September 2023. Page 24)

• Reuse – www.freecycle.org utilizes Yahoo groups organized by city and allows individuals to post items available for free, for reuse, so that other individuals can obtain used merchandise.

References

• Environmental Health: A Position Paper from the American College of Physicians (Ann Intern Med. 2022. 175. 1591-1593).

• Consumer Reports on Health. 4/05. 10 ways to reduce your exposure to chemicals.

• Bryson, Christopher. The Fluoride Deception. 2004.

• Carson, Rachel. Silent Spring. 1962.

• Cone, Maria. Silent Snow: The Slow Poisoning of the Artic.

• Dadd, Deborah Lynn. Home Safe Home: Creating a Healthy Home Environment by Reducing Exposure to Toxic Household Products. 2004

• Golos, Natalie. Success in the Clean Bedroom.

• Greenfield, Ellen. House Dangerous. 1991.

• Johnston, David and Gibson, Scott. Green from the Ground Up. 2008.

• Pizzorno, Joseph. The Toxin Solution. 2017.

• Rapp, Doris. Our Toxic World: A Wake Up Call. 2004.

• Rea, Bill. Your Home, Your Health, Your Wellbeing.

• Rider, Kimberly. The Healthy Home Workbook

• Sandbeck, Ellen. Green Housekeeping

• Schauss, Mark. Achieving Victory Over a Toxic World.

• Smith Rick and Lourie, Bruce. Slow Death by Rubber Duck. 2013.

• Smith Rick and Lourie, Bruce.Toxim Toxout: Getting Harmful Chemicals Out of Our Bodies and Our World. 2014.

Resources

• Agriculture - Rodale Institute

• Air pollution/quality

  • www.airnow.gov - web site administered by EPA and provides real time data on air quality at a given location

  • www.epa.gov/outdoor-air-quality-data/air-quality-statistics-report provides an average of air quality by location

• American Academy of Environmental Medicine www.aaem.com

• Building with sustainable design www.treehugger.com

• Bug repellants - natural bug repellant websites include www.bitestop.com, www.kokogm.com, www.herbalremedies.com, www.planetnatural.com/barriersrepellents, www.pestrepellents.com, www.natauralbabyproducts.com, www.equuskreen.com, www.thebackpacker.com, www.wisementrading.com, www.naturalfoodmerchandiser.com, www.heavenscentaroma.com, and www.quantumhealth.com (Perlmutter D. The Better Brain Book. 2004. Appendix 3).

• Collaborative on Health and the Environment – partnership of individuals and organizations to advance knowledge of environmental factors in health and illness, and foster interdisciplinary scientific collaborations. www.healthandenvironment.org

• Consumer’s Union evaluation of label claims. www.eco-labels.org

• Cosmetics – A Consumer’s Dictionary of Cosmetic Ingredients by Ruth Winter, www.safecosmetics.org and Environmental Working Group www.cometicsdatabase.com

• Environmental Health Center – Dallas – Dr William Rea 214-368-4132

• Environmental Health Sciences – informational website and email service, featuring in-depth analysis. www.environmentalhealthnews.org.

• Environmental Working Group www.ewg.org

  • Home Page - Dirty Dozen foods with the most pesticides – list posted at http://www.foodnews.org/walletguide.php

  • Safety data on more than 14,000 skin and other personal care products. Direct link is http://www.cosmeticsdatabase.com/index.php?nothanks=1.

• EPA Citizens Guide to Pest Control and Pesticide Safety www.epa.gov/oppfead1/Publications/Cit_Guide/citguide.pdf

• EPA and Purdue University Guide to Potentially Hazardous Chemicals www.epa.gov/grtlakes/seahome/housewaste//house/mainmenu.htm

• EPA - see also below pesticide product label info and pesticide resources

• Gardening

  • Websites on pesticide free gardening include www.eap.mcgill.ca/publications, www.organicgardening.com, www.pesticide.org, www.gardensalive.com, and www.pesticidefreeyards.org(Perlmutter D. The Better Brain Book. 2004. Appendix 3).

  • Books on organic gardening include Rodale’s Illustrated Encyclopedia of Organic Gardening (2002) and How to Get Your Lawn and Garden off Drugs (2002).

• Green Guard www.greenguard.org for green purchasing information

• Green Guide for Health Care www.gghc.org – provides guidance in choosing the lesser of evils

• Green Works – Chlorox Company biodegradable line of cleaning products

• Health Care Without Harm - 501c3 organization with membership based on a commitment to values and action. Global organization of hospitals, clinics, and individual practitioners dedicated to environmentally responsible health care and practical problem-solving. No dues - funded by foundations. Founded in 1996 to address ways to minimize adverse environmental impact associated with the delivery of health care and specifically the harmful substances found in health care devices and released into the environment by incineration of medical waste. www.hcwh.org or email info@hcwh.org. Green Guide www.gghc.org can be downloaded for free or purchased for $85 plus postage – integrates environmental and health principles planning, design, and construction of healthcare facilities.

• Home assessments for toxins and air quality

  • Indoor Air Professionals (Buffalo, NY) 716-683-3000

  • Aerotech Laboratories, 800-651-4802 evaluates buildings for dust, mold, and chemicals as per Dr. Doris Rapp in Our Toxic World (2004)

• Household Products Database (NLM) – information on potential health effects and chemicals contained in 6000 brand name household products – http://householdproducts.nlm.nih.gov

• Household Products greener choices – www.greenerchoices.org (a website of Consumers Union)

• Hospitals for a Healthy Environment – www.h2eonline.org – natural organization which offers technologies and strategies for creating a safe and efficient health care setting.

• Indoor environmental quality - CDC policy available at www.thecanaryreport.org

• Interfaith Climate Change Network www.protectcreation.org

• Lead test kits – see Consumer Reports 9/08, pgs 43-44 for ‘easy to use’ kits

• Mattresses (organic) - The Organic Mattress Store 866-246-9866 www.theorganicmattressstore.com or Essentia, www.myessentia.com

• Natural products for the home www.organicdivas.com

• Mold – mold websites and mold consultants are listed in Appendix C of Dr. Doris Rapp’s book, Our Toxic World (2004).

• NLM of the NIH Household Products Database - searchable information on potential health hazards of brand name products http://householdproducts.nlm.nih.gov

• Oceans Alive – rates fish and seafood www.oceansalive.org

• Organic Trade Association www.ota.com for further green purchasing information

• Pesticide free garden www.organicgardening.com

• Pesticide product label information www.epa.gov/pesticides/pestlabels

• Pesticide resources (electronic) including alternate pest-control measures www.epa.gov/oppfead1/pmreg

• RAC News and Legislative Alerts www.rac.org

• Rea, William J. Environmental Health Center. Dallas TX 75231 www.ehcd.com and inform@ehcd.com Foundation 1-800-824-2343

• Reuse – www.freecycle.org utilizes Yahoo groups organized by city and allows individuals to post items available for free, for reuse, so that other individuals can obtain used merchandise.

• Radon test kits -see Consumer Reports 9/08, pp 44-45 for info on kits

• Scorecard www.scorecard.org allows one to enter a zip code and obtain specific information on environmental toxins by zip code

• Teleosis Institute - non profit organization dedicated to dedicated to educating health professionals about the principles of ecologically sustainable medicine, providing practical tools tailored to the needs of individual practices and small clinics www.teleosis.org

Page Updated November 10, 2024